华法林治疗一度房室传导阻滞90例的效果观察  

Clinical observation of warfarin in the treatment of first-degree atrioventricular block: 90 cases

作　　者：黄华文[1] 周宏霞 秦锡祥[1] HUANG Hua-wen;ZHOU Hong-xia;QIN Xi-xiang(Department of Cardiology,Lianjiang People's Hospital,Lianjiang 524400,China;Lianjiang Hospital of Traditional Chinese Medicine,Lianjiang 524400,China)

机构地区：[1]广东省廉江市人民医院,广东廉江524400 [2]广东省廉江市中医院,广东廉江524400

出　　处：《广东医科大学学报》2020年第2期191-193,共3页Journal of Guangdong Medical University

基　　金：湛江市非资助科技攻关计划项目(No.2017B01119)。

摘　　要：目的观察华法林抗凝治疗一度房室传导阻滞的临床效果。方法 180例CHA2 DS2-VASc评分≥2分的一度房室传导阻滞患者随机分为抗凝组和对照组,每组90例,两组患者均予基础治疗及饮食健康指导,抗凝组在基础上给予华法林抗凝治疗,观察及比较两组治疗后12个月的日常生活能力评分(SF-36)及治疗后12个月内的临床终点事件和不良反应的发生率。结果治疗12个月后,抗凝组患者SF-36评分中的的生理功能、躯体疼痛、社会功能、情感职能、精神健康、社会功能与躯体疼痛评分均优于同期的对照组(均P<0.05或0.01)。抗凝组治疗后12个月内脑栓塞、外周血管栓塞、短暂性脑缺血发作发作及病死的总发生率低于对照组(P<0.05)。两组治疗后12个月内黑便、牙龈出血、鼻出血及皮肤瘀斑的总发生率的差异无统计学意义(P>0.05)。结论对CHA2 DS2-VASc评分≥2分的一度房室传导阻滞患者行抗凝治疗,可以安全、有效降低心脑血管事件的发生率,提升患者生活质量。Objective To observe the clinical effect of anticoagulation therapy of warfarin in patients with first-degree atrioventricular block. Methods A total of 180 cases of first-degree atrioventricular block with CHA2 DS2-VASc score ≥2 points were randomly divided into the Anticoagulant Group and the Control Group, 90 cases in each group. Both groups were given basic treatment and dietary health guidance while the Anticoagulant Group was additionally given the warfarin for anticoagulant therapy. The Short-Form 36 item Health Survey Questionnaire(SF-36) score and the incidence of clinical endpoint events and adverse reactions of the two groups at 12 months after the treatment were observed and compared. Results After 12 months of treatment, the physiological function, somatic pain, social function, emotional function, mental health, social function and somatic pain score in SF-36 scores in the Anticoagulant Group were superior to those in the Control Group(P<0.05 or 0.01 for all). The total incidences of cerebral embolism, peripheral vascular embolism, transient ischemic attack and death within 12 months after treatment in the Anticoagulant Group were lower than those in the Control Group(P<0.05). There was no significant difference in the total incidences of black stool, gingival bleeding, nosebleed and skin ecchymosis between the two groups within 12 months after treatment(P>0.05). Conclusion Anticoagulant therapy for patients with first-degree atrioventricular block and having the CHA2 ds2-vasc score ≥2 points can safely and effectively reduce the incidence of cardiovascular and cerebrovascular events and improve the quality of life of patients.

关 键 词：一度房室传导阻滞 华法林 抗凝治疗 

分 类 号：R541.7[医药卫生—心血管疾病]