非瓣膜性老年人房颤抗凝治疗的疗效与安全性

Utility and safety of anticoagulation therapy on non-valvular atrial fibrillation in the elderly

目的分析非瓣膜性老年人房颤患者应用华法林抗凝治疗的疗效和安全性。方法选择2009年2月—2011年2月在桐乡市中医医院就诊的年龄≥65岁心房颤动患者,随机分为华法林治疗组(30例)和阿司匹林对照组(30例),分别给予华法林和阿司匹林治疗,华法林初始剂量2.5 mg/d,根据INR目标值调整剂量,阿司匹林组给予阿司匹林100 mg/d。随访1年,观察2组缺血性脑卒中及出血并发症的发生率。结果华法林治疗组缺血性脑卒中发生率明显低于阿司匹林对照组,差异有统计学意义(P<0.05)。2组均无严重出血发生。结论严格控制INR情况下,非瓣膜性老年人房颤患者应用华法林抗凝治疗是安全有效的。

Objective To explore the utility and safety of anticoagulation therapy with warfarin on non-valvular atrial fibrillation in the elderly. Methods Total 60 aged patients（ ≥65 years） with atrial fibrillation in our hospital from February ,2009 to February ,2011 were enrolled in this study, and were randomly divided into Warfarin group（ 30 cases, received Warfarin 2.5 mg/d at first and the dose was adjusted according to INR target value） and Aspirin group （ 30 cases, received Aspirin 100 mg/d）. One-year follow-up study was performed to evaluate the incidence of isehemic stroke and bleeding. Results The incidence of isehemie stroke in the Warfarin treatment group was significantly lower than the aspirin group,the difference was statistically significant（ P 〈0. 05 ）. There was no severe bleeding case in both groups. Conclusion Under the strict control of INR, the anticoagulation therapy with warfarin on non-valvular atrial fibrillation was safe and effective in the elderly.