华法林与阿司匹林在CHADS2评分为1分的非瓣膜性房颤患者卒中预防作用的比较  

作　　者：姚昱皓 吴英[1] 孙钰 

机构地区：[1]浙江省海宁市人民医院,314499

出　　处：《浙江临床医学》2022年第5期697-698,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2015124944)。

摘　　要：目的 比较CHADS2评分1分心房颤动患者使用华法林或阿司匹林对卒中的预防作用.方法 选择2015年1月至2016年12月非瓣膜性心脏病CHADS2评分1分心房颤动患者137例.分为阿司匹林抗栓治疗组和华法林抗凝治疗组.收集患者的基线资料.每隔3个月进行门诊或电话随访,记录不良事件发生情况.观察主要终点为脑梗死,次要终点为颅内出血及其他出血、心功能恶化,比较华法林与阿司匹林治疗的有效性与安全性.结果 137例患者,男85例(69.9%),女52例(30.1%).华法林组55例(40.1%),阿司匹林组82例(59.8%).随访3~4年,随访期间脑血管栓塞发生17例(12.4%),全因死亡11例(8.0%).华法林抗凝组脑梗死事件发生低于阿司匹林抗栓组(5.5%VS.17.1%),差异有统计学意义(P<0.05).出血(1.5%VS.1.2%)、心功能下降(32.7%VS.21.9%)等差异无统计学意义(P>0.05).结论 CHADS2评分1分非瓣膜性心房颤动患者使用华法林比阿司匹林预防栓塞更有优势.Objective To compare the preventive effect of warfarin or aspirin on stroke in patients with atrial fibrillation with CHADS2 score of 1 point.Methods From January 2015 to December 2016,137 patients with nonvalvular heart disease with CHADS2 score of 1 point were selected.They were divided into the aspirin antithrombotic group and the warfarin anticoagulant group.Baseline data were collected.Outpatient or telephone followups were conducted every 3 months to record the occurrence of adverse events.The primary endpoint was cerebral embolism,and the secondary endpoints were intracranial hemorrhage,other hemorrhages,and deterioration of cardiac fiinction.The efficacy and safety of warfarin and aspirin were compared.Results Among 137 patients,85 were male(69.9%)and 52 were female(30.1%),with 55 patients(40.1%)in the warfarin group and 82 patients(59.8%)in the aspirin group.There were 17 cases(12.4%)of cerebral embolism and 11 cases(8.0%)of all-cause death during 3-4 years of follow-up.The incidence of cerebral embolism in the warfarin anticoagulant group was significantly lower than that in the aspirin antithrombotic group,with statistical significance。.5%VS.17.1%,(P<0.05).No statistically significant difference was found between the two groups in terms of the incidence of hemorrhage(1.5%VS.1.2%)and the decrease of cardiac fiinction(32.7%VS.21.9%).Conclusion Warfarin is more advantageous than aspirin in preventing embolism in patients with nonvalvular atrial fibrillation with CHADS2 score of 1 point.

关 键 词：心房颤动 CHADS2评分1分 脑梗死 华法林 阿司匹林 

分 类 号：R54[医药卫生—心血管疾病]