目的 觀察達(dá)比加群酯預(yù)防房顫患者卒中的療效及安全性。方法 納入房顫患者80例均符合抗凝治療指征。按照奇偶數(shù)法隨機(jī)分為觀察組（n=40）和對(duì)照組（n=40）。觀察組給予達(dá)比加群酯110 mg，2次/d；對(duì)照組給予華法林2.5 mg/d，并定期測(cè)定國(guó)際標(biāo)準(zhǔn)化比值（INR），根據(jù)INR調(diào)整劑量。兩組療程均為6個(gè)月。記錄兩組患者卒中、全身性栓塞和大出血發(fā)生情況。兩組患者出院時(shí)檢查凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）、纖維蛋白原（FIB）和D-二聚體等凝血指標(biāo)。結(jié)果 觀察組患者卒中/全身性栓塞的發(fā)生率為17.5%，對(duì)照組為37.5%，兩組患者卒中/全身性栓塞發(fā)生率有統(tǒng)計(jì)學(xué)差異（P<0.05）；觀察組患者大出血發(fā)生率顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者凝血功能指標(biāo)差異均無(wú)統(tǒng)計(jì)學(xué)意義。治療后，兩組血脂水平均較治療前顯著改善，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組血脂水平改善更為明顯，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 與華法林比較，對(duì)有房顫患者行抗凝治療達(dá)比加群酯具備同等療效，且安全性更高。

Objective To observe the efficacy and safety of dabigatran for stroke prevention in atrial fibrillation patients.Methods A total of 80 atrial fibrillation patients with indications to anticoagulant therapy were enrolled. They were randomly divided into observation group (n=40) and control group (n=40). The observation group was administered dabigatran 110 mg, twice a day; the control group was administered warfarin 2.5 mg/d, then the international normalized ratio (INR) was determined periodically. The dose of warfarin was adjusted according to INR. Both treatment course in the two groups were six months. We recorded the incidence of stroke, systemic embolism and massive hemorrhage in two groups, and compared the level of discharge PT, activated partial thromboplastin time (APTT), fibrinogen and D-dimer between two groups. Results The incidence of stroke/systemic embolism in the observation group was 17.5%, and in the control group was 37.5%, there was significant difference in the incidence of stroke/systemic embolism between two groups (P<0.05). The incidence of bleeding in the observation group was significantly lower than the control group (P<0.05). There was no significant difference in coagulation function between two groups. After treatment, the blood lipid levels of the two groups were significantly improved compared with those before treatment (P<0.05), and the improvement of blood lipid level in the observation group was more significant (P<0.05).Conclusion Compared with warfarin, dabigatran has the same efficacy and higher safety in patients with atrial fibrillation.