老年脑梗死并发心房颤动的抗凝治疗临床效果分析

Analysis of Clinical Effect of Anticoagulant Therapy of Senile Cerebral Infraction Combined with Auricular Fibrillation

目的探讨对老年脑梗死伴有心房颤动患者施以抗凝治疗后获得的临床效果。方法方便选择该院2014年5月—2017年11月收治的110例老年脑梗死患者作为实验对象;依据患者以往是否具有房颤史完成临床分组;分别设为A1组(房颤组55例)以及A2组(非房颤组55例)。临床对两组老年脑梗死患者展开抗凝治疗,最终对治疗结果展开对比分析。结果同A2组老年脑梗死患者甲状腺功能异常发生率(5.45%)、冠心病发生率(0.00%)以及以往脑梗死发生率(7.27%)进行比较,A1组表现出明显升高,差异有统计学意义(P<0.05);同A1组老年脑梗死患者应用华法林、阿司匹林、氯吡格雷药物治疗率与INR值达标率(分别为21.82%、23.64%、18.18%)进行比较,A2组无明显差异(P>0.05);同A2组老年脑梗死患者双抗治疗率(27.27%)比较,A1组双抗治疗率为47.27%,表现出明显提升,差异有统计学意义(χ~2=4.7048,P=0.0300)。结论对于老年脑梗死伴有心房颤动患者而言,在临床抗凝治疗效果方面欠缺理想,并且未获得显著INR值达标率,对此需要采取有效方法提高抗凝药物治疗效果,以降低房颤患者脑血管事件发生率。

Objective To study the clinical effect of anticoagulant therapy of senile cerebral infraction combined with auricular fibrillation. Methods 110 cases of senile cerebral infraction admitted and treated in our hospital from May 2014 to November 2017 were convenient selected and divided into two groups with 55 cases in each, including the A1 group and A2 group, namely the atrial fibrillation group and the non-atrial fibrillation group, and the patients in the two groups were for anticoagulant therapy, and the clinical treatment effect was compared and analyzed finally. Results The incidence rate of abnormal thyroid function in the A2 group, incidence rate of coronary heart disease and incidence rate of past cerebral infraction in the A2 group were respectively 5.45%, 0.00% and 7.27%, and the indicators obviously increased in the A1 group the different was statistically significant（P〈0.05）, and the differences in the treatment rate of warfarin, aspirin, clopidogrel drugs between the two groups were not obvious, which were respectively 21.82%, 23.64%, 18.18% in the A1 group（P〉0.05）, and the penicillin-streptomycin treatment rate in the A2 group obviously increased compared with that in the A1 group, （27.27% vs 47.27%）,（χ^2=4.7048,P=0.0300） . Conclusion The clinical anticoagulant therapy of senile cerebral infraction combined with auricular fibrillation is not ideal, without obtaining an obvious INR standards-reaching rate, therefore, we should use the effective method to improve the treatment effect and reduce the incidence rate of cerebrovascular accidents of atrial fibrillation patients.