住院心房颤动患者华法林的使用分析

Analysis of warfarin use in hospitalized patients with atrial fibrillation

目的分析比较瓣膜性心房颤动和非瓣膜性心房颤动住院患者华法林使用情况及国际标准化比值（INR）达标状况。方法收集969例住院心房颤动患者的病历资料进行回顾性分析。将患者分为瓣膜性心房颤动和非瓣膜性整体的心房颤动2组，分析2组华法林使用率和达标率的差异及应用华法林患者的INR达标水平。结果瓣膜性心房颤动患者161例中使用华法林者93例，占57.8%；非瓣膜性心房颤动患者808例中使用华法林者214例，占26.5%。93例使用华法林的瓣膜性心房颤动患者中，INR值在2.0～3.0者21例，占22.6%；214例使用华法林的非瓣膜性心房颤动患者中，INR值在2～3者38例，占17.8%。2组患者华法林的使用率比较差异有统计学意义（P＜0.05），INR达标率比较差异无统计学意义（P＞0.05）。使用华法林的307例心房颤动患者的达标率INR在2.0～3.0者59例，占19.2%；INR＜2.0者230例，占74.9%；INR＞3.0者为18例，占5.9%。结论华法林在心房颤动患者中的使用率低且使用华法林后INR的达标率低。

ObjectiveTo study the use of warfarin in valvular atrial fibrillation patients and nonvalvular atrial fibrillation patients; to observe the rate of reaching international normalized ratio（INR） standard after using warfarin. MethodsAll 969 cases of hospitalized patients with atrial fibrillation were divided into two groups, valvularatrial fibrillation group（161 cases） and nonvalvular atrial fibrillation group（808 cases）. The differences of warfarin utilization rate and success rate with statistical between two groups,and the overall success rate of INR of 307 patients who used warfarin in 969 atrial fibrillation patients were studied. ResultsRegarding the use of warfarin, there was a statistical difference between valvular atrial fibrillation patients and patients with nonvalvular atrial fibrillation （P〈0.05）; there was no difference of success rate [57.8%（（93/161） vs 26.5%（214/808）（P〉0.05） among 307 cases of atrial fibrillation with the use of warfarin. ConclusionThe utilization rate of warfarin is low in patients with atrial fibrillation and the INR success rate is low.