内科

目的探讨复方丹参滴丸联合达比加群酯胶囊在非瓣膜性心房颤动（NVAF）患者抗凝治疗中的应用效果。方法选取2017年2月至2019年2月在郑州市第九人民医院就诊的NVAF患者77例，根据患者意愿分为单药组（35例）和联合组（42例）。单药组患者给予达比加群酯胶囊抗凝治疗，联合组患者给予达比加群酯胶囊及复方丹参滴丸抗凝治疗，连续治疗2个月。检测比较两组患者治疗前、治疗2个月后的活化部分凝血活酶时间（APTT）、血浆凝血酶原时间（PT）、凝血酶时间（TT）及国际标准化比值（INR）；观察比较两组患者治疗期间的出血发生情况；治疗结束后随访1年，比较两组患者短暂性脑缺血、肺栓塞、深静脉血栓及心肌梗死等特殊事件的发生情况。结果治疗前，两组患者的APTT、PT、TT及INR水平比较，差异无统计学意义（P＞0.05）。治疗2个月后，两组患者的APTT、PT、TT及INR水平均显著升高，差异有统计学意义（P＜0.05）；联合组患者的APTT、PT、TT及INR水平均高于单药组，但差异无统计学意义（P＞0.05）。治疗期间，联合组患者的出血总发生率（7.14%）显著低于单药组（25.71%），差异有统计学意义（P＜0.05）。治疗结束后1年内，两组患者均未发生短暂性脑缺血发作、肺栓塞、深静脉血栓及心肌梗死等特殊事件。结论达比加群酯胶囊联合复方丹参滴丸治疗可有效改善NVAF患者的凝血状况，有效降低患者的出血风险。

ObjectiveTo explore the effect of compound Danshen dripping pills combined with dabigatran etexilate capsules applied to the anticoagulation treatment for patients with nonvalvular atrial fibrillation (NVAF). MethodsA total of 77 NVAF patients who were hospitalized in the Ninth People′s Hospital of Zhengzhou from February 2017 to February 2019 were selected, and they were divided into single-drug group (35 cases) and combination group (42 cases) according to the patient′s wishes. Patients in the single-drug group received anticoagulation therapy with dabigatran etexilate capsules, and patients in the combination group received the above therapy combined with compound Danshen dripping pills, for a two-month continuous treatment. The activated partial thromboplastin time (APTT), plasma prothrombin time (PT), thrombin time (TT) and international normalized ratio (INR) before and after 2 months of treatment were tested and compared between the two groups. The hemorrhage during the treatment was observed and compared between the two groups. Oneyear follow-up after treatment, the occurrence of special events including transient cerebral ischemia, pulmonary embolism, deep vein thrombosis, and myocardial infarction, etc. was compared between the two groups. ResultsBefore treatment, there were no statistically significant differences in APTT, PT, TT and INR levels between the two groups (P＞0.05). After 2 months of treatment, the levels mentioned above increased significantly, with statistically significant differences (P＜0.05). Compared with the single-drug group, the combination group yielded higher levels of APTT, PT, TT and INR, but the differences were not statistically significant (P＞0.05). During the treatment, the total incidence of hemorrhage in the combination group was significantly lower than that in the single-drug group (7.14% vs. 25.71%), with a statistically significant difference (P＜0.05). Within 1 year after the treatment, no special events including transient cerebral ischemia, pulmonary embolism, deep vein thrombosis, and myocardial infarction, etc. occurred in both groups. ConclusionDabigatran etexilate capsules combined with compound Danshen dripping pills can effectively improve the coagulation status of patients with NVAF, and effectively reduce the risk of bleeding in patients.