华法令对非瓣膜病性房颤患者血栓形成的干预作用

The Intervention of Warfarin in Treatment of Non-valvular Patients with Chronic Atrial Fibrillation

目的 探讨华法令对于非瓣膜病性心房颤动患者抗凝治疗的临床效果 ,摸索出深圳地区NVAF患者华法令抗凝治疗的有效安全剂量。 方法 对符合本研究标准的 74例老年心房颤动患者随机分为华法令治疗组和阿司匹林对照组 ,华法令治疗组 3 6例 ,给予华法令 3mg/d开始 ,监测凝血酶原时间 (PT )及国际标准化比值 (INR) ,连续观察 4周使INR在 2 .0～ 3 .0范围内 ,以后每月查 1次INR。若病人需增加或减少药物或有出血倾向时随时再测INR ;阿司匹林对照组 3 8例 ,给予阿司匹林 3 0 0mg/d ,分 2次服用。 结果 华法令治疗组PT监测 ,第 1、2、4、8周 ,均较用药前有显著性差异 (P <0 .0 5 ) ;随访期间 ,华法令治疗组脑卒中的发生率为 2 .8% ,阿司匹林对照组为 13 .2 % ,两组比较有显著性差异 (P<0 .0 5 ) ;两组均未见明显的出血等副作用。 结论 深圳地区非瓣膜病性心房颤动患者选择华法令 3～ 4mg/d抗凝治疗是安全有效的。

Objective To assess the effectiveness and security of warfarin in treatment of anticoagulation in non-valvular patients with chronic atrial fibrillation. Method The patients of chronic atrial fibrillation were divided into two groups randomly, i.e. warfare group and aspirine group . PT and INR of all patients were detected, the warfarin group were administered 3 mg/d dose of Warfarin. PT and INR were detected every other day. One week later, the dosage of warfarin was increased to 4 mg/d if INR did not reach 2.0-3.0. INR was detected every other week until it reached about 2.0-3.0. Four weeks later, INR was detected every month. When the patients were inclined to have hemorrhagia symptom, their INR was detected immediately. The patients of aspirin group were administered aspirin 300mg orally twice a day. Results In warfarin group , PT was significantly lower than that before treatment, P<0.05. The ratio of cerebral embolism was 2.8% in Warfarin group, and 13.2% in aspirin group , P<0.05. Conclusion 3-4mg dose of oral warfarin in chronic Af patients with INR in the range of 1.8-2.5 is effective, safe and convenient.