老年非瓣膜病性心房颤动患者华法林钠抗凝疗效及安全性研究

Antithrombotic effect and safety of warfarin in elderly with nonvalvular atrial fibrillation

目的探讨老年非瓣膜病性心房颤动（AF）患者华法林钠（华法林）抗凝治疗的安全性和有效性。方法160例老年（≥75岁）非瓣膜病性持续性AF患者，随机分入调整剂量华法林组和阿司匹林（300mg／d）组。观察国际标准化比值（INR）1．80～2．50时华法林剂量、血栓栓塞事件与出血风险。结果INR1．80～2．50时华法林剂量1．43～3．57mg／d，平均（2．373±0．304）mg／d。160例患者中，发生血栓栓塞13例（8．1％）。其中华法林组2例（2．5％），阿司匹林组11例（13．8％），两组间差异有统计学意义（P〈0．05）。轻微出血：华法林组7例（8．8％），阿司匹林组5例（6．3％），差异无统计学意义（P〉0．05）；两组均无严重出血。结论严密监测INR情况下，老年AF患者应用华法林抗凝治疗是安全有效的。

Objective To investigate antithrombotic effect and safety of adjusted-dose warfarin preventing thrombo-embolism in the elderly with nonvalvular atrial fibrillation. Methods One hundred and sixty eases diagnosed as nonvalvular atrial fibrillation in the hospital were divided into two groups randomly： warfarin group（international normalized ratio, INR 1.80--2.50） and aspirin control group （300 mg/d）. The effect of warfarin was observed and the incidence of the side-effects such as thrombo-embolism and hemorrhagic was compared. Results The dose of warfarin achieved the goal by the INR was varied from 1.43 mg/d to 3.57 mg/d,arithmetie mean （2. 373±0. 304） mg/d. The cases of thrombo-embolism in warfarin group were 2 （2. 5%）, in aspirin group were 11 （13.8%）. The incidence of thrombo-embolism in aspirin group was higher than that in warfarin group（ P〈0.05）. The rates of minor bleeding were 7 cases（8.8%） in warfarin group and 5 eases（6.3%） in aspirin group（ P 〉0.05）. No serious bleeding occurred in two groups. Conclusion Adjusted-dose warfarin can safely and remarkably reduce the incidence of thrombo-embolism in elderly patients with nonvalvular atrial fibrilation.