华法令在慢性房颤患者中的应用研究  

Application study of warfarin in patients with chronic atrial fibrillation

作　　者：黄淑田[1] 佟金谕[1] 陈秀兰[2] 仝珊[1] 

机构地区：[1]山西医科大学第二医院心内科,太原市030001 [2]山西医科大学第二医院药剂科,太原市030001

出　　处：《中国心血管病研究》2007年第7期515-517,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的分析慢性心房颤动(AF)患者的抗凝治疗状况与未抗凝的原因以及华法令预防血栓栓塞的疗效和安全性。方法收集198例慢性房颤患者与抗凝有关的病历资料进行分析,并根据应用抗凝药物不同分为:华法令组(53例)、阿司匹林[300mg/d,33例]和阿司匹林[(100～150)mg/d,45例]3组进行对比。结果①144例(72.7%)伴有血栓栓塞高危因素,53例(36.8%)采用了华法令抗凝,78例(54.2%)予以阿司匹林抗栓。②91例(63.2%)未用华法令原因:53.8%为医生指导问题,33.0%为患者问题。③三组比较仅见华法令组与阿司匹林(100～150mg/d)两组间栓塞发生率差异具有统计学意义(P<0.01),均未见明显不良反应发生。结论①房颤患者中华法令应用不足,加强医生常见相关知识,积累华法令应用经验,对患者进行脑卒中预防常识的普及,有助于提高华法令的正确使用率。②华法令疗效肯定、用药安全、副作用少,应根据危险分层权衡栓塞和出血的利弊,使大多数卒中高危的房颤患者能从合理的抗凝治疗中获益。Objective To analyse condition in treatment of anticoagulation, cause of unanticocgulation and effect and security of warfarin in patients with chronic atrial fibrillation. Methods Cases data relating to anticoagulation were collected detailed in 198 patients with chronic atrial fibrillation, they were divided into three groups according to difference of using anticoagulation medicines, warfarin （53 cases）,aspirin （300 mg/d,33 cases） and aspirin [100-150）mg/d,45 cases]group, respectively. Results （1）There were some high risk factors of thrombo-embolism in 144 cases （72.7%）,warfarin was used in 53 cases （36.8%） and aspirin （100-300 mg/d） was used in 78 cases（54.2%）. （2）The causes of that warfarin was not used in 91 cases（63.2%）include：53.8% for doctors and 33.0% for patients. （3）In the incidence of thrombo-embolism.Tbere was significant difference between warfarin and aspirin groups （100-150 mg/d）（P〈0.01）.there was no significant difference in the incidence of by-effect among three groups. Conclusion （1）Applying of warfarin was more less, studing hard and accumulating clinical experience benefited to enhance rate of correct using of warfarin. （2）Warfarin was safe and effective for patients with atrial fibrillation, the doctors should balance the incidence of thrombo-embolism and hemorrhage on the basis of different risk, so majority patients with atrial fibrillation with stroke risk benefited from rational＇ anticoagnlation treatment.

关 键 词：心房颤动 华法令 抗凝药 

分 类 号：R541.75[医药卫生—心血管疾病]