低强度华法林抗凝对老年非瓣膜性房颤患者肾功能、血栓栓塞及出血发生率的影响

Effects of Low-intensity Warfarin Anticoagulation on Renal Function,Incidence of Thromboembolism and Bleeding in Elderly Patients with Non Valvular Atrial Fibrillation

目的:探讨低强度华法林抗凝对老年非瓣膜性房颤患者肾功能、血栓栓塞及出血发生率的影响。方法:回顾性分析福建省立医院2017年7月-2019年7月收治的66例老年非瓣膜性房颤患者,根据华法林抗凝治疗强度分为两组,各33例;低强度组:国际标准化比率(international normalized ratio,INR)为1.6~2.0;标准强度组:INR为2.1~3.0。比较两组的肾功能、血栓栓塞及出血发生率。结果:治疗后6、12、24个月,两组的血肌酐(Scr)均逐渐降低,肌酐清除率(Ccr)均逐渐升高,且低强度组优于标准强度组,差异有统计学意义(P<0.05);两组的血栓栓塞发生率比较,差异无统计学意义(P>0.05),但低强度组的出血率低于标准强度组,差异有统计学意义(P<0.05)。结论:老年非瓣膜性房颤采用低强度华法林抗凝可明显改善肾功能,预防出血,值得推广。

Objective:To investigate the effect of low-intensity Warfarin anticoagulation on renal function,incidence of thromboembolism and bleeding in elderly patients with non valvular atrial fibrillation.Method:A total of 66 elderly patients with non valvular atrial fibrillation treated in Fujian Provincial Hospital from July 2017 to July 2019 were retrospectively analyzed.They were divided into two groups according to the intensity of Warfarin anticoagulation treatment,33 cases each group.The low-intensity group:the international normalized ratio (INR) was 1.6-2.0,the standard strength group:INR was 2.1-3.0.The renal function,the incidence of thromboembolism and the bleeding of the two groups were compared.Result:At 6,12 and 24 months after treatment,the serum creatinine (Scr) of the two group were decreased,and the creatinine clearance rate (Ccr) were increased,and the low-intensity group were better than those in the standard strength group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of thromboembolism between the two groups (P>0.05),but the bleeding rate in the low-intensity group was lower than that in the standard strength group,and the difference was statistically significant (P<0.05).Conclusion:Low-intensity Warfarin anticoagulation can significantly improve renal function and prevent bleeding in elderly patients with non valvular atrial fibrillation,which is worthy of promotion.