老年冠心病心房颤动患者华法林抗凝及强化降脂联合治疗安全性的临床观察

Efficacy and safety of the combination of intensive lipids-lowering therapy with wayfaring in elderly coronary heart disease patients with atrial fibrillation

目的观察老年冠心病心房颤动患者强化降脂联合华法林抗凝治疗的疗效及安全性。方法60例老年冠心病心房颤动患者,随机分为治疗组和对照组。治疗组给予华法林联合阿托伐他汀口服,维持国际标准化比率(INR)2.0～3.0;对照组给予阿司匹林联合阿托伐他汀口服。观察治疗过程中的脑卒中、出血及其它不良反应。结果缺血性脑卒中年发生率治疗组3.3%,对照组26.7%,两组相比较,差异有统计学意义(P<0.05)。出血年发生率治疗组10.0%,对照组6.7%,两组比较,差异无显著性(P>0.05)。结论华法林联合阿托伐他汀治疗老年冠心病心房颤动,栓塞事件发生率低,用药安全。

【Objective】To observe the efficacy and safety of warfarin combined with atorvastatin in the treatment of atrial fibrillation in the old patients with coronary heart disease.【Methods】Sixty patients with atrial fibril- lation were divided into warfarin group （therapy group, n =30） and aspirin group （control group, n =30） randomly. In warfarin group patients received warfarin anticoagulation treatment, the INR ranged from 2 to 3. The patients in con- trol group received aspirin treatment. Atorvastatin medication 40mg per day was given for every patient. INR and effect were observed at different time point respectively.【Results】The annual incidence of ischemical stroke was 3.3% in the therapy group and 26.7% in control group and respectively, there was significant difference between them. However, the annual incidence of hemorrhage was 10.0% in the therapy group and 6.70% in control group, there was no significant difference between them, and both were no severe hemorrhage. 【Conclusions】Antithrombotic therapy with warfarin in the old patients with atrial fibrillation can significantly reduce the risk of cardio-embolic stroke, and it is effective and safe.