论著DOI：10.16662/ki.1674-0742.2023.10.023抗凝治疗在心内科房颤患者中的应用效果分析王墨茹莱州市人民医院心内科，山东莱州261400［摘要］目的分析抗凝治疗在心内科房颤患者中的应用效果。
方法方便选取2021年2月—2022年2月莱州市人民医院心内科收治的房颤患者96例为研究对象，采用抛硬币法分为观察组（n=49）和对照组（n=47）。
所有患者入院后均视个体情况予控制血压、降血糖，改善心肌缺血、控制心率及预防心力衰竭等常规治疗。
对照组在常规治疗的基础上予华法林钠片治疗，观察组在常规治疗的基础上采用利伐沙班片治疗。
两组均持续治疗4周，治疗后随访6月。
对比分析两组患者随访期间不适症状发生情况、不良事件发生情况及治疗后凝血功能指标和肾功能指标。
结果治疗后，两组凝血功能指标均改善，凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）均增加，观察组长于对照组，差异有统计学意义（P<0.05）；两组纤维蛋白原水平均降低，观察组低于对照组，差异有统计学意义（P<0.05）。
治疗后，两组肾功能各指标均上升，观察组血肌酐（Scr）、尿素氮（BUN）均低于对照组，差异有统计学意义（P<0.05）。
观察组不适症状总发生率为6.12%（3例），低于对照组的21.28%（10例），差异有统计学意义（χ2=4.706，P=0.030）。
随访期间观察组不良事件总发生率4.08%（2例）低于对照组28.57%（14例），差异有统计学意义（χ2=11.413，P<0.001）。
结论房颤患者应用利伐沙班抗凝治疗可以效减少脑血栓等不良事件、出血风险的发生率，降低患者的病死率，改善其凝血功能。
［关键词］抗凝治疗；心房颤动；华法林；利伐沙班；不良事件；凝血功能［中图分类号］R4 ［文献标识码］A ［文章编号］1674-0742（2023）04(a)-0023-05Analysis of the Application Effect of Anticoagulant Therapy in Patients with Atrial Fibrillation in the Department of CardiologyWANG MoruDepartment of Cardiology, Laizhou People's Hospital, Laizhou, Shandong Province, 261400 China[Abstract] Objective To analyze the application effect of anticoagulant therapy in patients with atrial fibrillation in Department of Cardiology. Methods A total of 96 atrial fibrillation patients admitted to the Department of Cardiology, Laizhou People's Hospital from February 2021 to February 2022 were conveniently selected as the research objects. They were divided into observation group (n=49) and control group (n=47) by flipping a coin. After admission, all pa⁃tients were treated with conventional treatments such as controlling blood pressure, lowering blood glucose, improving myocardial ischemia, controlling heart rate and preventing heart failure according to individual conditions. The control group was treated with warfarin sodium tablets on the basis of conventional treatment, and the observation group was treated with rivaroxaban tablets on the basis of conventional treatment. Both groups continued treatment for 4 weeks, and were followed up for 6 months after treatment. The occurrence of discomfort symptoms, adverse events, blood co⁃agulation function indexes and renal function indexes after treatment were compared and analyzed between the two groups of patients during the followup period. Results After treatment, the coagulation function indexes of the two groups were improved, and the thrombin time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) increased, and the observation group was longer than the control group, and the difference was statistically sig⁃nificant (P<0.05). The levels of fibrinogen in both groups decreased, and the observation group was lower than the con⁃trol group, and the difference was statistically significant (P<0.05). After treatment, all indexes of renal function in the [作者简介] 王墨茹（1973-），女，本科，副主任医师，研究方向为心内科。
