抗Xa水平对心房颤动合并肾功能不全抗凝治疗指导意义.docVIP

抗Xa水平对心房颤动合并肾功能不全抗凝治疗指导意义 　　[摘要] 目的 探讨抗Xa水平监测对心房颤动合并肾功能不全患者低分子肝素钠抗凝治疗中的指导意义。 方法 选取我院于2012年5月～2015年5月收治的心房颤动合并肾功能不全患者96例作为研究对象，依据随机数字表法分为观察组和对照组，各48例。所有患者均给予基础治疗，在此基础上，对照组给予普通肝素钠常规治疗，观察组给予低分子肝素钠抗凝治疗。观察对比两组疗效指标。对所有患者给予抗Xa水平检测，分析其与治疗效果各因子之间的相关性。 结果 治疗后观察组TC、LDL、TG、hs-CRP水平均较对照组显著降低（P0.05），而HDL、HGB水平显著升高（P0.05），且两组出血状况等级比较差异有统计学意义（P0.05）；抗Xa水平分组中，各项疗效指标差异均具有统计学意义（P0.05），抗Xa水平和疗效指标存在相关性，且以抗Xa≥0.4 IU/mL且1.0 IU/mL时为最佳，既可以保证抗凝效果，又可以减少出血状况。 结论 采用低分子肝素钠抗凝治疗对心房颤动合并肾功能不全患者疗效显著，且抗Xa水平和疗效指标具有一定相关性，因此可以对其水平进行监测，以评估和指导低分子肝素钠抗凝治疗。 　　[关键词] 抗Xa水平监测；心房颤动；肾功能不全；低分子肝素钠；抗凝治疗 　　[中图分类号] R541.75；R692 [文献标识码] A [文章编号] 1673-9701（2016）11-0004-05 　　[Abstract] Objective To explore and study the guiding significance of anti-Xa levels monitoring in the treatment of low molecular weight heparin sodium anticoagulation therapy of patients with atrial fibrillation complicated with renal insufficiency. Methods A total of 96 cases of patients with atrial fibrillation complicated with renal insufficiency in our hospital from May 2012 to May 2015 were selected as the research subjects， who were divided into observation group and control group， with 48 cases in each group. All patients were treated with basic treatment. On this basis， the control group was treated with conventional heparin sodium， and the observation group was treated with low molecular weight heparin sodium anticoagulation. Curative effect indexes of the two groups were observed and compared. All patients were detected with anti-Xa levels， and the correlations between them and curative effect indexes were analyzed. Results After treatment， the levels of TC， LDL， TG and hs-CRP in the observation group were significantly lower than those in control group（P 　　[Key words] Anti-Xa levels monitoring； Atrial fibrillation； Renal insufficiency； Low molecular weight heparin sodium； Anticoagulation therapy 　　心房颤动是临床上最为常见的持续性恶性心律失常，且该病随着年龄的增长发病率不断升高。据统计[1]，在75岁以上老年人群中，心房颤动的发病率高达10%。心跳不规则加快、心房收缩功能减弱是该病最为常见的临床表现。心房颤动和高血压、心力衰竭、冠心病、慢性肾功能不全等疾病密切相关，其