不同剂量华法林抗凝治疗高龄稳定性冠心病合并非瓣膜性心房颤动患者的效果  

Effect of different doses of warfarin anticoagulation in the treatment of elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation

作　　者：宋程 邹婕 张佳静 SONG Cheng;ZOU Jie;ZHANG Jiajing(Department of Internal Medicine,Baoshihua Tuha Hospital of Hami City,Hami,Xinjiang,839009,China)

机构地区：[1]哈密市宝石花吐哈医院内科,新疆哈密839009

出　　处：《当代医学》2023年第34期94-97,共4页Contemporary Medicine

摘　　要：目的探究不同剂量华法林抗凝治疗高龄稳定性冠心病合并非瓣膜性心房颤动患者的疗效。方法选取2017年6月至2020年1月哈密市宝石花吐哈医院收治的82例高龄稳定性冠心病合并非瓣膜性心房颤动患者作为研究对象,根据华法林不同使用剂量分为A组(低剂量)与B组(标准剂量),每组41例。比较两组主要与次要终点事件、安全性终点事件及国际标准化比值(INR)、凝血酶原时间(PT)变化情况。结果治疗1、6、12、24个月,两组主要终点(体循环栓塞、缺血性脑卒中)、次要终点(全因死亡联合终点、非致命性心肌梗死)发生率比较差异无统计学意义。A组牙龈出血、皮肤黏膜出血发生率均低于B组,差异有统计学意义(P<0.05);两组消化道出血、血尿、脑出血发生率比较差异无统计学意义。INR达标后1个月,两组INR均高于治疗前,PT均长于治疗前,但A组INR低于B组,PT短于B组,差异有统计学意义(P<0.05)。结论低剂量华法林抗凝治疗高龄稳定性冠心病合并非瓣膜性心房颤动患者的效果与标准剂量相近,但是安全性高于标准剂量。Objective To explore the efficacy of different doses of warfarin anticoagulation in the treatment of elderly patients with stable coro-nary heart disease complicated with non-valvular atrial fibrillation.Methods A total of 82 elderly patients with stable coronary heart disease compli-cated with non-valvular atrial fibrillation treated in Baoshihua Tuha Hospital of Hami City from June 2017 to January 2020 were selected as the study subjects.,they were divided into the group A(low dose)and the group B(standard dose)according to different doses of warfarin,with 41 cases in each group.The main and secondary endpoint events,safety endpoint events,and changes in international normalized ratio(INR)and prothrombin time(PT)were compared between the two groups.Results After 1,6,12 and 24 months of treatment,there were no significant differences in the in-cidence of main endpoint(systemic embolism,ischemic stroke)and secondary endpoint(combined endpoint of all-cause death,non-fatal myocardial infarction)between the two groups.The incidence of gingival bleeding and skin mucosal bleeding in the group A were lower than those in the group B,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of gastrointestinal bleeding,he-maturia and cerebral hemorrhage between the two groups.1 month after reaching INR standard,INR of the two groups were higher than that before treatment,PT was longer than that before treatment,but the INR in the group A was lower than that in the group B,and PT in the group A was shorter than that in the group B,the differences were statistically significant(P<0.05).Conclusion The efficacy of low dose warfarin anticoagulation in the treatment of elderly patients with stable coronary heart disease complicated with non-valvular atrial fibrillation is similar to that of standard dose,but the safety is higher than standard dose.

关 键 词：华法林 抗凝疗法 非瓣膜性心房颤动 高龄 冠心病 

分 类 号：R541.75[医药卫生—心血管疾病]