华法林在高龄房颤患者中不同抗凝强度的疗效及安全性分析

The efficacy and safety of antithrombotic therapy with warfarin in eldly aterial fibrillation

目的探讨华法林对高龄心房颤动患者不同抗凝强度抗凝的疗效和安全性。方法入选高龄（≥80岁）住院的心房颤动患者84例,根据房颤血栓危险度评分≥2分的给予华法林抗凝,根据国际标准化比值（international normalized ratio,INR）随机分为低强度组（INR：1.6~2.0）和标准强度组（INR：〉2.0~3.0）,分析两组的血栓栓塞和出血事件。结果血栓栓塞事件发生率低强度组与标准强度组的差异无显著性（P〉0.05）。出血事件发生率低强度组低于标准强度组,差异有显著性（P〈0.05）。结论高龄老年房颤患者应用华法林抗凝,将INR控制在1.6~2.0更有效、安全。

Objective To study the efficacy and safety of antithrombotic therapy with warfarin in eldly aterial fibrilla-tion. Method The 84 patients aged over 80 years were randomly assigned into 2 groups. 44 patients in low-intensity warfarin anticoagulation group （target value of INR 1. 6~2. 0）,the other 40 patients in standard–intensity warfa-rin anticoagulation group （target value of INR〉2. 0~3. 0 ）. Main outcome measures included the incidence rates of bleeding and thromboembolic events. Result The incidence rate of thromboembolic events was 4. 76% in low-intensi-ty group and 4. 76% in standard-intensity group（P〉0. 05）. The incidence rate of bleeding events was significantly lower in low-intensity group than in standard-intensity group （P〈0. 05）. Conclusion To acheieve optimal levels of anticoagulation in eldly patients with atrial fibrillation, value of INR is 1. 6~2. 0 Under intense monitoring,adjusted dose warfarin （INR ：1. 6~2. 0） is effective and safe for the high risk atrial fibrillation patients over 80 years.