不同强度华法林预防非瓣膜性房颤患者栓塞性疾病的效果观察  

Observation of effect of different intensity of warfarin in prevention of embolic diseases in patients with non-valvular atrial fibrillation

作　　者：陈健佳[1] CHEN Jian-jia(Department of Internal Medicine-Cardiovascular,Foshan Shunde District Lecong Hospital,Foshan 528315,China)

机构地区：[1]广东省佛山市顺德区乐从医院心内科,528315

出　　处：《中国实用医药》2020年第3期95-96,共2页China Practical Medicine

摘　　要：目的观察分析不同强度华法林预防非瓣膜性心房颤动(房颤)(NVAF)患者栓塞性疾病的效果。方法130例非瓣膜性房颤患者,根据随机抽签法分为观察组与对照组,各65例。两组患者用药前均测定国际标准化比值(INR)作为基础值,并照INR调整用药强度,观察组给予华法林初始剂量2 mg/d,INR控制在1.7~2.5;对照组给予华法林初始剂量2.5 mg/d,INR控制在2.6~3.0,同时两组患者均给予其他常规药物治疗。随访2年,观察比较两组患者脑栓塞、出血及死亡率。结果观察组发生脑栓塞4例(6.15%)、出血3例(4.62%)、死亡1例(1.54%),对照组发生脑栓塞3例(4.62%)、出血10例(15.38%)、死亡2例(3.08%)。两组患者脑栓塞、死亡率比较差异无统计学意义(P>0.05),观察组出血率显著低于对照组,差异具有统计学意义(P<0.05)。结论对非瓣膜性房颤患者,华法林强度为INR1.7~2.5时脑栓塞发生率显著降低,且可减少出血事件的发生。Objective To observe and analyze the effect of different intensity of warfarin in prevention of embolic diseases in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 130 patients with non-valvular atrial fibrillation were divided into observation group and control group by random lottery method,with 65 cases in each group.The international normalized ratio(INR)was measured as the basic value before the treatment in both groups,and the medication intensity was adjusted according to INR.The initial dose of warfarin in the observation group was 2 mg/d,INR was controlled at 1.7-2.5,the initial dose of warfarin in the control group was 2.5 mg/d,INR was controlled at 2.6-3.0,and the patients in both groups were treated with other conventional drugs.After 2 years follow-up,cerebral embolism,hemorrhage and mortality rate were observed and compared between the two groups.Results The observation group had 4 cases(6.15%)of cerebral embolism,3 cases(4.62%)of hemorrhage and 1 case(1.54%)of mortality;the control group had 3 cases(4.62%)of cerebral embolism,10 cases(15.38%)of hemorrhage and 2 cases(3.08%)of mortality.There was no statistically significant difference in cerebral embolism and mortality between the two groups(P>0.05).The hemorrhage rate in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion For patients with nonvalvular atrial fibrillation,the incidence of cerebral embolism was significantly reduced when warfarin intensity was 1.7-2.5 of INR,and the incidence of hemorrhage events is also reduced.

关 键 词：不同强度华法林 非瓣膜病心房颤动 脑栓塞 

分 类 号：R541.75[医药卫生—心血管疾病]