不同抗凝强度华法林预防非瓣膜性房颤血栓栓塞的临床研究  

Clinical Study of Different Anticoagulate Intensity of Warfarin in Prevention of Nonvalvular Atrial Fibrillation

作　　者：曾建辉[1] 陈晓平[1] 蒋凌云[1] 彭清[1] 苏艳玲[1] 

机构地区：[1]四川大学华西医院心内科,四川成都610041

出　　处：《华西医学》2009年第1期55-57,共3页West China Medical Journal

摘　　要：目的：探讨不同抗凝强度华法林应用于非瓣膜性心房颤动患者的可行性及安全性。方法：91例非瓣膜性心房颤动患者随机分为三组：低抗凝强度[国际标准化比率（INR）1．5～1．91；标准抗凝强度组（INR2．0～2．5）和阿司匹林组，观察三组血栓栓塞并发症和出血等不良反应的发生率以及c-反应蛋白浓度变化。结果：标准抗凝强度组血栓发生率低于低抗凝强度组、阿司匹林组，不同强度华法林抗凝组血栓栓塞率比较差异无统计学意义；标准抗凝强度组出血发生率低于其他两个组，但三组患者出血发生率比较无统计学意义（P〉O．05）；治疗后低抗凝强度组、标准抗凝强度组c-反应蛋白浓度明显低于治疗前（P〈O．05），治疗后阿司匹林组c-反应蛋白水平明显高于低抗凝强度组、标准抗凝强度组（P〈0．01）。结论：华法林抗凝维持INR值在2．O～2．5时能降低非瓣膜性房颤患者血栓栓塞发生率，出血发生率低，有效性和安全性好。Objective：To investigate the efficacy and safety of Warfarin different anticoagulation intensities and aspirin preventing thrombo embolism in nonvalvular atrial fibrillation. Methods： Ninty one patients with non-valvular atrial fi- brillation were divided into three groups randomly： low-dose warfarin group （INR 1. 5 - 1.9） ;standard dose warfarin group （INR 2.0-2.5 ）;aspirin control group,INR-specified rates for both ischemic and major hemorrhagic events and C-reactive protein concentration were analyzed. Results：The lowest incidence of thrombo-embolism and hemorrhage were standard-dose warfarin group. The comparison of the incidence of hemorrhage in the three groups was not significant va- riance（P〉0.05）. The concentrations of C-reactive protein in low-dose warfarin group and standard close warfarin group were lower than those before the treatment （P〈0.05） . After the therapy,the C-reactive protein concentration in aspirin control group was significantly higher than the other two groups （P〈0.01）. Conclusion：When INR maintains standard anticoagulation intensity between 2.0 and 2.5 can safely and effectively reduce the incidence of thrombo-embolism and bleeding in patients with nonvalvular atrial fibrillation.

关 键 词：非瓣膜病 血栓栓塞 华法林 阿司匹林 C-反应蛋白 

分 类 号：R541.75[医药卫生—心血管疾病]