华法林与新型口服抗凝药物引起消化道出血风险的比较.docVIP

精品论文 参考文献 华法林与新型口服抗凝药物引起消化道出血风险的比较 欧阳蓉 　　（柳州市工人医院消化内科一病区 广西柳州 545005） 　　【摘要】 目的：比较华法林与新型口服抗凝药物（利伐沙班、达比加群）引起的消化道出血的风险。方法：对6例服用华法林致消化道出血（华法林组）和5例服用新型抗凝药物（利伐沙班、达比加群）致消化道出血（新型抗凝药物组）的患者的临床资料进行回顾性分析。比较两组的消化道出血在服用药物之后的发生时间、出血特点、住院时间，建立Cox比例风险模型进行两类抗凝药物引起消化道出血的风险评估。结果：两组在引起消化道出血的出血量、严重程度、住院时间以及内镜下表现比较差异无统计学意义(Pgt;0.05)。新型口服抗凝药物组引起消化道出血发生在服用药物100天之类的比率为77.8%，而华法林组比率为41.6%。Cox比例风险模型显示同时服用其他抗血小板聚集药物如阿司匹林、氯吡格雷、噻氯吡啶等会加重消化道出血的严重程度。（Plt;0.05）。结论：华法林与新型口服抗凝药物引起消化道出血的特点以及住院之间比较无统计学差异，但服用药物100天内出血消化道出血的发生率新型口服抗凝药物组明显高于华法林组。并且同时服用其他抗血小板聚集药物会加大消化道出血的严重程度。 　　【关键词】 消化道出血；华法林；新型口服抗凝药物 　　【中图分类号】R453 【文献标识码】A 【文章编号】1007-8231（2015）15-0087-02 　　Comparing the risk of gastrointestinal (GI) bleeding with novel oral anticoagulants(dabigatran, rivaroxaban,) and warfarin 　　【Abstract】Objective Comparing the risk of gastrointestinal (GI) bleeding with novel oral anticoagulants(dabigatran, rivaroxaban,) and warfarin.Methods The clinical data of 6 cases of GI bleeding caused by warfarin (warfarin group) and 5cases of GI bleeding caused by novel oral anticoagulants(dabigatran, rivaroxaban,) (novel oral anticoagulants group) were collected, the occurrence time of GI bleeding, severity, hospital stay and endoscopy resultsl between the groups were compared. The risk factors of GI bleeding were analyzed by Coxrsquo;s regression model. Results The severity, hospital stay and endoscopy resultsl between the groups were no statistically difference (Pgt;0.05). There was a higher incidence of GI bleeding during the first 100 days( 77.8%) when compared to warfarin group (41.6%). The Coxrsquo;s regression model analysis showed that the concomitant use of aspirin, thienopyridines, and dual anti-platelet agents will increase the risk of GI bleeding （Plt;0.05）.Conclusion The severity, hospital stay and endoscopy resultsl between the groups were no statistically difference.the patients who were on ovel oral anticoagulants for le;100 days had a higher incidence of GI b