慢性肾功能不全对房颤患者使用华法林的影响

Influence of chronic renal failure on usage of warfarin in patients with atrial fibrillation

目的探讨慢性肾功能不全对阵发性房颤患者使用华法林的影响。方法选择确诊的103例阵发性房颤患者,按是否合并慢性肾功能不全分为两组:观察组(伴有肾功能不全)和对照组(无肾功能不全),两组均使用华法林辅助抗凝治疗。比较华法林治疗后两组患者的国际标准化比值(INR)、出血事件发生率、脑卒中发生人数和华法林相关肾病发生率。结果观察组的INR值为2.71±0.79,对照组的INR值为2.24±0.82,观察组INR值高于对照组,差异有统计学意义(t=2.96,P<0.05),观察组INR>2.5的人数多于对照组,差异亦有统计学意义(χ2=9.92,P<0.05)。观察组患者出血、脑卒中和华法林相关肾病发生率均高于对照组,差异均有统计学意义(χ2分别=7.78、6.13、16.32,P均<0.05)。结论房颤伴慢性肾功能不全患者使用华法林治疗后,各种不良反应发生率相比不伴有肾功能不全的患者明显升高,抗凝血作用也增强。

Objective To explore the effect of chronic renal failure on usage of warfarin in patients with atrial fibrillation. Methods A total of 103 patients with clinical confirmed paroxysmal atrial fibrillation were divided into two groups according to whether complicated with chronic renal failure or not. Patients in both groups received anticoagulant therapy through warfarin. The INR,incidence of bleeding evens and warfarin-related nephropathy, stroke were compared. Results The INR value of the observation group was 2.71±0.79 which was significantly higher than the control group that the INR value was 2.24±0.82 （t=2.96,P〈0.05）.The number of INR〉2.5 in observation group were more than the control group （X^2=9.92 ,P〈0.05）. The incidence of bleeding evens, stroke and warfarin-related nephropathy in observation group were significantly higher than those of the control group （X^2=7.78,6.13,16.32,P〈0.05）. Conclusion The incidences of various adverse reactions in patients with atrial fibrillation combined with chronic renal failure received warfarin therapy are significantly higher than those without renal failure as well as the anticoagulant effect.