低剂量华法林预防心房颤动患者脑栓塞的临床研究

Clinical study of low-dose warfarin on preventing thromboembolism in preventing patients with atrial fibrillation

目的:评价低剂量华法林预防心房颤动患者发生脑栓塞的有效性和安全性。方法:将86例持续性心房颤动患者随机分为A组(n=43)及B组(n=43)。所有患者均给予基础疾病治疗,A组接受华法林1.25 m/d(低剂量)抗凝治疗,B组接受华法林2.5 mg/d(较高剂量)抗凝治疗,常规门诊随访1年,检测国际标准化比值(INR),必要时调整华法林剂量,并记录两组患者的脑栓塞终点事件及出血并发症事件。结果:低剂量华法林抗凝与较高剂量华法林抗凝相比,脑栓塞事件的发生率无显著差别(4.6%vs 2.3%),而出血并发症明显低于较高剂量华法林对照组(4.7%vs 20.9%,P<0.05)。结论:低剂量华法林预防心房颤动发生脑栓塞并发症安全有效。

Objective： To evaluate the efficacy and safety of low-dose warfarin on preventing cerebral embolism in atrial fibrillation patients. Methods： Eighty-six patients with persistent atrial fibrillation were randomly divided into 2 groups ： the observation group of low-dose （ 1.25 rag/d） warfarin （ n = 43 ）, and the control group of higher dose （2.5 mg/d） warfarin （n = 43 ）. The dosage of warfarin was adjusted according to the international normalized ratio （INR） when necessary. Events of cerebral embolism and bleeding complications were compared during one year follow-up. Results： There was no sign ificant difference of the cerebral embolism events between the two groups （4.6% vs 2.3% ）. The bleeding complications in low-dose of warfarin group was significantly lower than that in the higher dose warfarin control group （4.6% vs 20.9% , P 〈 0. 05 ）. Conclusion： Low-dose warfarin is safe and effective in preventing cerebral embolism complications in patients with atrial fibrillation.