老年综合评估与干预对高龄非瓣膜性房颤抗凝疗效及安全性影响的研究

Effect of Comprehensive Geriatric Assessment and Intervention on the Effectiveness and Safety of Anticoagulation of Elders with Non-valvular Atrial Fibrillation

探讨老年综合评估(CGA)及干预对高龄非瓣膜性房颤(NVAF)患者华法林抗凝疗效及安全性的影响。选择年龄≥80岁、接受华法林抗凝治疗的NVAF住院患者158例,随机分成两组:试验组75例,进行华法林抗凝治疗同时行CGA及针对性干预,对照组83例,仅进行华法林抗凝治疗,随访12个月~24个月。主要观察终点为栓塞及出血事件发生率。结果显示,总栓塞发生率及总出血发生率试验组分别为3.23%、4.84%,对照组分别为15.1%、26.4%,差异具有统计学意义(P<0.05);提示常见老年综合征的评估与干预可提高高龄NVAF患者华法林抗凝治疗的有效性及减少出血风险。

To investigate the comprehensive geriatric assessment（CGA）and intervention on the effectiveness and safety of warfarin anti-coagulation in very elderly patients with non-valvular atrial fibrillation（NVAF）.158 elders aged greater than or equal to 80 with NVAF and without anticoagulation contradictions were selected,and they were separated in to two groups randomly.The experimental group which included 75 cases were suggested to accept with warfarin anti-coagulation and Comprehensive Geriatric Assessment and intervention;The control group which included 83 cases were only treated with warfarin anti-coagulation.All the patients were followed up with in 12-24 months.The main purpose of the measurement is the incidence of thromboembolic and bleeding events.The incidence rates of thromboembolic and bleeding events were 3.23%,4.84%in experimental group,and 15.1%,26.4%in control group.And the difference between the two groups are statistically significant（P〈0.05）.CGA and intervention enhance significantly the effectiveness and the safety of warfarin anti-coagulation in elder patients with non-valvular atrial fibrillation.