调整剂量的华发林对非瓣膜性心房颤动患者缺血性脑卒中的预防效果及安全性研究  

Study on efficiency and safety of adjusted-dose Warfarin in preventing ischemic stroke of patients with non valvular atrial fibrillation

作　　者：祁学成 黄小婷 陈新岩 王梅 蒲新菊 

机构地区：[1]银川长庆石油医院心内科,宁夏750006

出　　处：《中国急救医学》2007年第11期1018-1020,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的研究调整剂量的华发林预防非瓣膜性心房颤动(NVAF)患者缺血性脑卒中的疗效和安全性。方法选择2004—01～2006—10间确诊为NVAF的住院患者79例,随机分成华发林治疗组和常规对照组。华发林组38例,给予华发林1.5～3.5 mg/d;目标国际标准化比值(INR)为2.0～3.0。对照组41例,未用华发林。所有患者均给予基础疾病治疗,以脑卒中发病率作为疗效判定。结果华发林组脑卒中3例(7.8%),对照组脑卒中10例(25.0%)。缺血性脑卒中事件华法林组较常规对照组相对危险性下降68.8%(P<0.05)。华发林组出血事件为5例,其中脑出血1例(占2.6%),皮下淤血2例(5.3%)、牙龈出血2例(5.3%),总出血发生率为13.2%。常规对照组出血事件1例,皮肤紫癜1例,总出血事件发生率为2.4%。华发林组出血的危险性高于常规对照组(P<0.05),但多数出血并发症发生在INR>3.0的患者。结论严密检测(INR 2.0～3.0)下调整剂量的华发林对NVAF患者抗卒中治疗疗效确切,安全性好。Objectives To study the efficiency and safety of adjusted - dose Warfarin in preventing ischemic stroke of patients with non valvular atrial fibrillation. Methods 79 patients diagnosed as non valvular atrial fibrillation in our hospital from January 2004 to October 2006 were randomly divided into two groups：Warfarin group and control group. 38 cases were in adjusted -dose warfarin group（ international normalized ratio, 2 ~ 3） and took anticoagulants Warfarin from 1.5 mg/d to 3.5 mg/d; 41 cases were in control group and treated without the anticoagulants, and all the patients were treated with routine treatment. The incidence of ischemic stroke was worked out . Results Number of ischemic strokes in group Warfarin was 3 （ 7.8% ） , in control group was 10 （ 25% ） , the incidence of isehemic stroke were more higher in control group than in Warfarin group（ P 〈 0.05 ） , and relative risk of the ischemic stroke decreased by 68.8% in Warfarin group. There was 5 patients with bleeding in Warfarin group： 1 cases was cerebral hemorrhage, 2 cases subcutaneous hemorrhage and 2 cases gum bleeding. Only 1 cases with bleeding in control group was gum bleeding. Bleeding rate was higher in Warfarin group than in control group（ 13.2% vs 2.4% , P 〈 0.05 ）. All the major bleeding events occurred in the patients with INR above 3.0. Conclusion Under intensive monitoring, adjusted - dose Warfarin is effective and safe in preventing ischemic stroke of patients with non valvular atrial fibrillation.

关 键 词：华发林 国际标准化比值 脑卒中 抗凝 

分 类 号：R541.75[医药卫生—心血管疾病]