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目的评估利伐沙班用于心房颤动导管消融术后抗凝治疗的有效性及安全性。方法将接受房颤射频导管消融的患者分为利伐沙班组(57例)和华法林组(100例)。利伐沙班组:房颤导管消融术后给予10 mg,2次/d或20 mg,1次/d口服,服用1个月后根据不同临床情况调整剂量,给予10 mg 1次/d或20 mg 1次/d再服用1个月。华法林组:房颤导管消融术后给予华法林3~6 mg/d,根据国际标准化比值(INR)调整剂量,控制INR在2.0~3.0,共服用2个月。所有患者从抗凝开始到抗凝结束选用同一种抗凝药物。结果基线水平的比较除性别外其他指标均无统计学差异。两组有效性及安全性比较:华法林组和利伐沙班组均未发生血栓栓塞事件(死亡、脑栓塞、肺栓塞、体循环栓塞)。两组均无大出血事件发生;不明显出血事件利伐沙班组为5%(3/57)、华法林组为11%(11/100),差异无统计学意义。结论口服利伐沙班用于血栓栓塞低、中危房颤患者导管消融术后抗凝安全有效。
Objective To evaluate the efficacy and safety of rivaroxaban in anticoagulant therapy after atrial fibrillation catheter ablation. Methods Patients undergoing RF catheter ablation were divided into rivaroxaban group (57 cases) and warfarin group (100 cases). In rivaroxaban group, patients were given 10 mg, 2 or 20 mg once daily after ablation of atrial fibrillation catheter. After 1 month, the dose was adjusted according to different clinical conditions and given 10 mg once daily or 20 days mg 1 time / d for another 1 month. Warfarin group: After atrial fibrillation catheter ablation, warfarin was given 3 ~ 6 mg / d, adjusted according to the international normalized ratio (INR) to control the INR at 2.0 ~ 3.0 for 2 months. All patients from anticoagulant to anticoagulant use the same anticoagulant drugs. Results There was no significant difference in other indexes between baseline and baseline except sex. Efficacy and safety comparison between the two groups: no warfarin and rivaroxaban thromboembolism events (death, cerebral embolism, pulmonary embolism, systemic embolism). No major bleeding occurred in either group. No significant bleeding was observed in 5% of patients in rivaroxaban group (3/57) and 11% (11/100) in warfarin group, with no significant difference. Conclusions Oral rivaroxaban is safe and effective for anticoagulation after catheter ablation in patients with low and moderate risk of atrial fibrillation.