城郊高龄老年房颤患者华法林治疗的安全性

Safety of warfarin treatment in advanced aged patients with atrial fibrillation living in suburbs

目的：探讨城郊高龄老年房颤患者应用华法林的安全性.方法：选择100例资料完整的老年房颤患者,按照数字表法,被随机分为华法林组（51例）：华法林起始剂量1.25 mg,1次/d.每隔3d测定血浆凝血酶原时间国际标准化比值（INR）1次.2～4周达到目标范围,如INR未达标,每隔1周增加华法林0.625 mg,直到INR控制在2.0～3.0.INR稳定前门诊随访每周监测1次,INR稳定后每4周监测1次;阿司匹林组（49例）：阿司匹林,100 mg,1次/d.结果：与阿司匹林组比较,华法林组血栓栓塞等终点事件发生率明显降低（19.15％比3.92％,P=0.017）,出血等不良反应发生率无显著差异（4.25％比5.88％,P＞0.05）.结论：高龄老年房颤患者应用华法林,能显著降低栓塞发生率,而且是安全的.

Objective.. To explore the safety of warfarin in advanced aged patients with atrial fibrillation （AF） living in sub- urbs. Methods： A total of 100 aged AF patients with complete data were selected, according to number table method, they were ranaomly divided into warfarin group （n = 51, loading dose of warfarin was 1.25mg, once/d. International normal- ized ratio （INR） was measured every three days. ICR was expected to reach target range in 2-4 weeks, if INR didrft reach target, warfarin dose was increased by 0. 625mg every one week until INR was controlled in 2. 0-3.0. INR was monitored once/week on outpatient follow-up before it＇s stable, and once/4 weeks after it＇s stable） and aspirin group （n-- 49, received aspirin 100mg once/d）. Results： Compared with aspirin group, there was significant reduction in incidence rate of endpoint events （such as thromboembolism etc. ） （19.15% vs. 3. 92%, P = 0. 017） in warfarin group. But there was no significant difference in incidence rate of adverse reactions （such as hemorrhage etc. ） （4. 25% vs. 5. 88%, P〉0. 05） between aspirin group and warfarin group. Conclusion： Warfarin could significantly reduce the incidence rate of embolism and is safe in ad- vanced-aged patients with atrial fibrillation.