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目的:评估非瓣膜病性房颤患者应用利伐沙班抗凝治疗相较华法林的代谢获益,及利伐沙班应用的安全性和有效性。创新点:首次研究利伐沙班对房颤射频消融术后患者代谢水平影响,评估利伐沙班相较华法林抗凝治疗的代谢获益。方法:前瞻性入选2014年4月至7月共60例行经皮房颤导管射频消融术患者,随机分为利伐沙班治疗组和华法林治疗组。在术后15、30、60和90天检测代谢指标(包括血清总蛋白、白蛋白、球蛋白和高密度脂蛋白(HDL)等)变化,并随访出血、卒中和系统性栓塞事件等发生情况。结论:服用利伐沙班抗凝治疗患者在随访期间血清总蛋白、白蛋白、球蛋白和HDL水平较术前均显著升高,而华法林治疗组患者各项代谢指标呈先下降、后上升趋势。两组均没有发生死亡和栓塞事件,出血并发症发生率亦无明显差异。研究结果表明,非瓣膜病性房颤患者经导管射频消融术后接受利伐沙班抗凝具有代谢方面获益,与华法林相比两者在安全性和有效性方面无明显差异,研究结果可为临床选择合适抗凝方案提供参考。
OBJECTIVE: To evaluate the metabolic benefits of rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and the safety and efficacy of rivaroxaban in its application. Innovative point: The first study of rivaroxaban in patients with atrial fibrillation after radiofrequency ablation of patients with metabolic effects, evaluation of rivaroxaban warfarin compared to the metabolic benefits of warfarin therapy. METHODS: A total of 60 patients undergoing radiofrequency ablation of percutaneous atrial fibrillation (AF) were prospectively enrolled from April 2014 to July 2014 and were randomly divided into rivaroxaban-treated group and warfarin-treated group. Metabolic parameters (including serum total protein, albumin, globulin, and high density lipoprotein (HDL), etc.) were measured at 15, 30, 60 and 90 days after operation and followed up for bleeding, stroke and systemic embolism . CONCLUSION: The levels of total protein, albumin, globulin and HDL in patients treated with rivaroxaban anticoagulant therapy during the follow-up period were significantly higher than those before the operation, while the metabolic indices of warfarin group decreased first and then Upward trend. No death or embolism occurred in either group, nor did the incidence of bleeding complications. The results show that patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation of rivaroxaban anticoagulation benefit from metabolic, compared with warfarin in the safety and efficacy of no significant difference between the results of the study Can provide a reference for clinical choice of appropriate anticoagulation.