低强度抗凝治疗对高龄心房颤动患者的疗效及安全性探讨  

Effectivity and safety of low-intensity warfarin anticoagulation in elderly patients with nonvascular atrial fibrillation

作　　者：卜庆锋[1] 焦殿雷[1] 李法祥[1] 

机构地区：[1]解放军第三七一中心医院,河南新乡453000

出　　处：《临床军医杂志》2015年第9期969-970,973,共3页Clinical Journal of Medical Officers

摘　　要：目的：探讨低强度抗凝治疗对高龄（≥80岁）非瓣膜性心房颤动患者的疗效及安全性。方法选择住院的高龄非瓣膜性心房颤动患者192例，按随机抽签法分为低强度组和标准强度组，各96例，进行华法林抗凝治疗。低强度组目标国际标准化比值（INR）控制在1.5～2.0；标准强度组目标INR控制在2.0～3.0。观察两组患者随访1年期间的各种出血并发症及各种血栓栓塞事件发生率。结果在随访1年期间中，低强度组和标准强度组血栓栓塞事件发生率分别为5.2%（5/96）和4.2%（4/96），差异无统计学意义（P＞0.05）。但低强度组各种出血事件的发生率低于标准强度组，两组分别为6.3%（6/96）和17.7%（17/96），差异有统计学意义（P＜0.05）。结论在高龄非瓣膜性心房颤动患者中，采用目标INR控制在1.5～2.0低强度的抗凝治疗，与常规标准抗凝治疗的疗效比较，差异无统计学意义（P＞0.05），而出血事件及风险明显减少（P＜0.05）。Objective To investigate the effectiveness and safety of low-intensity warfarin anticoagulation in over 80-year-old patients with nonvascular atrial fibrillation （NVAF）. Methods Totally 192 NVAF patients aged over 80 years were randomly devided into 2 groups：96 patients in low-intensity warfarin anticoagulation group （target value of INR 1. 5～2. 0）,the other 96 patients in standard-intensity warfarin anticoagulation group （target value of INR 2. 0 ～3. 0）. All patients were followed up outpatient-department for 1 year. Main outcome measures included the incidence rates of bleeding and thromboembolic events. Results The incidence rate of thromboembolic events was 5. 2% （4/90） in low-intensity group and 4. 2%（4/96） in standard-intensity group with no statistically significant difference between these two groups （P〉0. 05）. However,the incidence rate of hemorrhage was significantly lower in low-intensity group than in standard-intensity group[6. 3%（6/96） vs 17. 7%（17/96）,P〈0. 05]. Conclusion Therapy with low-inten-sity warfarin anticoagulation in NVAF patients aged over 80 years may be equally effective,but safer than that with standard-intensity warfarin.

关 键 词：心房颤动 华法林 高龄患者 低强度 

分 类 号：R541.75[医药卫生—心血管疾病]