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目的比较不同抗栓治疗方案对老年非ST段抬高型心肌梗死并心房颤动患者的影响。方法选取2013年3月—2015年11月遂宁市中心医院收治的老年非ST段抬高型心肌梗死并心房颤动患者162例,根据抗栓治疗方案分为A组48例、B组37例、C组41例和D组36例。A组患者给予阿司匹林+氯吡格雷治疗,B组患者给予华法林治疗,C组患者给予华法林+氯吡格雷治疗,D组患者给予华法林+阿司匹林+氯吡格雷治疗;4组患者均连续治疗1年。比较4组患者出血发生率、出血风险及血栓栓塞事件发生率、血栓栓塞风险。结果 D组患者出血发生率高于A、B、C组(P<0.05);A、C、D组患者出血风险与B组比较,差异无统计学意义(P>0.05)。C组患者血栓栓塞事件发生率低于A、B、D组,D组患者血栓栓塞事件发生率低于A、B组,A组患者血栓栓塞事件发生率低于B组(P<0.05)。A、D组患者血栓栓塞风险与B组比较,差异无统计学意义(P>0.05),而C组患者血栓栓塞风险低于B组(P<0.05)。结论随着抗栓强度增强,老年非ST段抬高型心肌梗死并心房颤动患者血栓栓塞风险降低,但出血风险升高。
Objective To compare the effects of different antithrombotic regimens on elderly patients with atrial fibrillation and non-ST elevation myocardial infarction. Methods A total of 162 elderly patients with non-ST-segment elevation myocardial infarction and atrial fibrillation admitted from Suining Central Hospital from March 2013 to November 2015 were divided into group A (n = 48), group B (n = 37) 41 cases in group C and 36 cases in group D. Patients in group A received aspirin + clopidogrel, patients in group B received warfarin, patients in group C received warfarin plus clopidogrel, patients in group D received warfarin plus aspirin plus clopidogrel, and patients in group 4 Patients were treated for 1 year. Bleeding incidence, bleeding risk, thromboembolic events and thromboembolism risk were compared among the four groups. Results The incidence of hemorrhage in group D was higher than that in groups A, B and C (P <0.05). The risk of hemorrhage in groups A, C and D was not significantly different from that in group B (P> 0.05). The incidence of thromboembolism in group C was lower than that in groups A, B and D. The incidence of thromboembolism in group D was lower than that in groups A and B. The incidence of thromboembolism in group A was lower than that in group B (P <0.05). The risk of thromboembolism in group A and group D was not significantly different from that in group B (P> 0.05), but the risk of thromboembolism in group C was lower than that in group B (P <0.05). Conclusion With the enhancement of antithrombotic intensity, the risk of thromboembolism in elderly patients with non-ST-segment elevation myocardial infarction and atrial fibrillation is reduced, but the risk of bleeding is increased.