阿司匹林联合双嘧达莫在非瓣膜性心房颤动患者抗栓治疗中的应用

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1、授予单位代码10089_学号或申请号13943HebeiMedicalUniversity硕士学位论文在职科学学位阿司匹林联合双嘧达莫在非瓣膜性心房颤动患者抗栓治疗中的应用学位申请人：耿清峰导师：郭艺芳教授专业：内科学二级学院：河北省人民医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料

2、、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。目录中文摘要·············································································1英文摘要·································

3、············································3英文缩写·············································································5研究论文阿司匹林联合双嘧达莫在非瓣膜性心房颤动患者抗栓治疗中的应用前言·············································································6材料与方法··························

4、··········································8结果·············································································10附表·············································································12讨论································································

5、·············14结论·············································································17参考文献·······································································17综述非瓣膜性心房颤动的抗凝治疗药物进展·····························22致谢··············································

6、·····································38个人简历·············································································39中文摘要阿司匹林联合双嘧达莫在非瓣膜性心房颤动患者抗栓治疗中的应用摘要目的：在不适合服用华法林的非瓣膜性心房颤动(NVAF)患者中，对比研究阿司匹林单药治疗与阿司匹林和双嘧达莫联合治疗的有效性（血栓栓塞事件风险）及安全性（出血事件发生率），为我国（特别是边远贫困地区）非瓣膜性房颤患者的抗凝治疗提供

7、新依据。方法：选择于2012年7月至2014年5月在河北省第七人民医院心内科门诊及住院的非瓣膜性房颤患者，按照入选标准共选择198例CHADS2评分至少为1分的患者，随机分为2组：阿司匹林联合双嘧达莫（联合治疗组）给予阿司匹林（100mg，每日一次）＋双嘧达莫（100mg，每日三次)；阿司匹林组给予（100mg，每日一次)。门诊随访察两组血栓栓塞事件（缺血性脑卒中、外周动脉栓塞）、各种出血事件（颅内出血、胃肠道、泌尿系、皮肤黏膜等出血）及其他不良反应的发生率，并比较它们之间的差异性。结果：1198例NVAF患者中联合治疗组96例，阿司匹

8、林组102例。各组患者一般资料比较（包括合并疾病及用药）差异无统计学意义(P>0.05)。2两组患者CHADS2评分比较差异无统计学意义(P>0.05)，平均CHADS2评分为2.7分。3随访时间10~20