华法林对慢性房颤患者凝血和抗凝指标的影响  

Effects of warfarin on blood coagulation and anticoagulation indexes of patients with chronic atrial fibrillation

作　　者：陆卫华[1] 杨剑虹[1] 韩璇[1] 方庆[1] 李刚[1] 唐忠志[1] 

机构地区：[1]广州军区武汉总医院急诊科,武汉430070

出　　处：《西南国防医药》2013年第9期949-952,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探索华法林在慢性心房颤动(房颤)中的应用效果及其对慢性房颤患者凝血和抗凝指标变化的影响。方法入选83例慢性房颤患者,根据经食道超声心动图分为血栓组(21例)和无血栓组(62例),其中血栓组予以华法林口服治疗(5 mg/d),无血栓组随机分为服药组(31例)和未服药组(31例),服药组治疗方法同血栓组。治疗3个月后,比较分析各组治疗前后及组间的血液指标的变化情况以及治疗效果。结果与无血栓组相比较,血栓组患者的AT-Ⅲ和tPA水平均较低,而DD水平偏高(P<0.05)。血栓组患者服用华法林后,AT-Ⅲ和tPA较治疗前升高,而DD水平较治疗前降低(P<0.05)。无血栓患者中,服药组服用华法林后,AT-Ⅲ和tPA较未服药组升高,而DD水平较未服药组降低(P<0.05)。结论华法林可以很好地防治慢性房颤患者血栓形成。Objective To investigate the application effects of warfarin on blood coagulation and anticoagulation indexes of patients with chronic atrial fibrillation. Methods Eighty three patients with chronic atrial fibrillation were selected and divided into two groups of thrombus group （21 cases ）and non-thrombus group （62 cases ）according to the results of TEE examination. The thrombus group orally took warfarin 5 mg/d. Patients in the non-thrombus group were randomly divided into warfarin group（ n = 31 ）and took the same dosage of medicine as the thrombns group and non-warfarin group （ n = 31 ）. After three month of treatment, comparison and analysis were made in the changes of blood indexes and curative effects before and after the treatment and among different groups. Results Compared with the indexes of the non-thrombus group, the levels of AT- Ⅲ and tPA in the thrombus group were lower, and the DD level was higher（ P 〈 0.05 ）. After the administration of warfarin in the thrombus group, the levels of AT- Ⅲ and tPA increased, and the DD level decreased compared with the levels before the administration （P 〈 0.05 ）. Among the patients without thrombus, the levels of AT-Ⅲ and tPA in the warfarin group increased after the administration ,but its DD level decreased compared with those in the non- warfarin group （ P 〈 O. 05 ）. Conclusion Warfarin is helpful to the prevention and treatment of thrombosis in patients with chronic atrial fibrillation.

关 键 词：慢性心房颤动 华法林 凝血和抗凝 

分 类 号：R541.7[医药卫生—心血管疾病]