心房颤动患者低强度抗凝与抗血小板治疗及蛋白C及S活性改变  

Low Intensity Anticoagulation Versus Antiplatelet Therapy in Patients with Atrial Fibrillation and Changes of Protein C and S Activity

作　　者：刘培光[1] 李素新[1] 李海涛[1] 周智宏[2] 

机构地区：[1]河北联合大学附属医院心内科,唐山063000 [2]河北联合大学附属医院感染性疾病科,唐山063000

出　　处：《医学研究杂志》2015年第11期88-90,121,共4页Journal of Medical Research

基　　金：唐山市科技局基金资助项目(12150209A)

摘　　要：目的观察口服华法林低强度抗凝相对于阿司匹林抗血小板治疗对心房颤动血栓事件的作用，并探讨血浆蛋白C及蛋白s活性变化及临床意义。方法选择笔者医院于2012年6月～2013年6月收治72例老年心房颤动患者作为研究对象，采用数字表法随机分组，每组36例，观察组采取华法林低强度抗凝，初始剂量为2．5mg／d，调整剂量使INR控制在1．5～2．5，对照组采取阿司匹林治疗，均测定两组患者抗凝前后血浆蛋白C及蛋白S活性，比较两组患者疗效及血浆蛋白C及蛋白S活性。结果两组出血发生率比较差异无统计学意义（P〉0．05）。观察组共血栓发生率1（2．78％）明显低于对照组6例（16．67％）（P〈0．05）。抗凝后观察组Pc、Ps活性均低于对照组（P〈0．05）。观察组抗凝后与抗凝前比较Pc、Ps活性降低（P〈0．05）。结论口服华法林低强度抗凝应用于心房颤动患者效果明显，低强度华法林虽降低血浆蛋白C及蛋白S活性，并未增加血栓事件发生率。Objective To investigate effect of low intensity anticoagulation versus antiplatelet therapy for prevention of thromboembo- lism in patients with non - valvular atrial fibrillation, and observe the changes of Protein C and S ability. Methods A total of 72 cases of patients with atrial fibrillation admitted in our hospital from June 2012 to June 2013 were enrolled and divided into two groups with 36 ca- ses in each group randomly. The treatment group received warfarin with first dose of 2.5rag followed by this dose per day and INR were controlled at 1.5 -2.5 by dose titration. The control group received aspirin 100mg per day, and plasma Protein C and Protein S activity were measured before and after treatment. Results The bleeding rate had no significant difference between two groups （P 〉 0.05）. The incidence of thrombosis in the treatment group was 2.78% and significantly lower than that of the control group （ 16.67% , P 〈 0.05 ）. After anticoagulation, the activity of PC and PS in observation group were lower than that of the control group（P 〈 0.05）. PC and PS ac- tivity in the treatment group decreased significantly after anticoagulation（P 〈 0.05）. Conclusion The effect of low intensity anticoagula- tion on prevention of thromboembolism in patients with non - valvular atrial fibrillation is obvious, and low intensity anticoagulation de- creased activity of protein C and protein S with no elevated rate of thrombosis.

关 键 词：华法林 低强度抗凝 心房颤动 蛋白C活性 蛋白S活性 国际标准化比率(INR) 

分 类 号：R541[医药卫生—心血管疾病] R743[医药卫生—内科学]