华法林对围生期心肌病患者抗凝治疗的临床研究  

Clinical research on warfarin for anticoagulation therapy in peripartum cardiomyopathy

作　　者：李世煌 陈瑛 唐春仕 刘科峰[2] 刘向儒 

机构地区：[1]郴州市第四人民医院,湖南郴州423000 [2]郴州市湘南学院,湖南郴州423000

出　　处：《现代医药卫生》2012年第13期1929-1930,共2页Journal of Modern Medicine & Health

摘　　要：目的比较不同疗程的华法林在围生期心肌病(PPCM)中的抗凝疗效。方法将符合诊断标准的42例围生期心肌病患者,在充分抗心力衰竭治疗的同时,按入院顺序,随机分为A组(20例,华法林治疗3个月)和B组(22例,华法林治疗6个月),调整华法林剂量使国际标准化比值(INR)维持在2.0～3.0之间,并比较两组治疗前后及两组间血浆D-二聚体含量、深静脉血栓形成及出血发生率。结果两组患者血浆D-二聚体治疗前后比较差异有统计学意义(P<0.05),两组间治疗后比较差异有统计学意义(P<0.05);治疗后A组的深静脉血栓形成的发生率高于B组,且差异有统计学意义(P<0.05);两组的出血发生率差异无统计学意义(P>0.05)。结论服用华法林6个月较服用华法林3个月治疗围生期心肌病,疗效及安全性均更佳,可以降低血管栓塞等严重并发症的发生和改善预后。Objective To compare the anticoagulation effects of different treatment courses of warfarin tor treating peri- partum cardiomyopathy （PPCM）. Methods At the same time of full anti-heart failure therapy,42 patients with PPCM were ran- domly divided into the group A （n=20,warfarin treatment for 3 months） and the group B （n=22,warfarin treatment for 6 months） according to the order of admission. Warfarin dose was adjustecl to maintain the international normalized ratio（]NR） of 2.0-3.0. Plasma D-dimer leve, the incidence rates of deep venous thrombosis and hemorrhage events before and after trealment were com- pared between the two groups. Results The levels of D-dimer before and after treatment had statistical difference between the two groups （P〈0.05）, and which after treatment showed statistical differences between the two groups （P〈O.05）. The incidence rate of deep venous thrombosis in the group A was higher than that in the group B with statistical difference （P〈O.05）. The incidence rate of hemorrhage events had no statistical difference between the two groups （/9〉0.05）. Conclusion Antieoagulation therapy of 6- month warfarin for treating PPCM is superior to 3-month warfarin therapy in curative effects and safety, which can reduce the occurrence of severe complications such as vessel embolism and improve the prognosis.

关 键 词：妊娠并发症/治疗 心肌疾病/治疗 华法林/治疗应用 血栓性静脉炎/治疗 D-二聚体 深静脉血栓 

分 类 号：R714.252[医药卫生—妇产科学]