老年心房颤动病人华法林抗凝治疗的有效性安全性评价

Assessment of effectiveness and security of wanfarin in treatment of anticoagulation in old patients with Chronic Atrial Fibrillation

目的 评价华法林用于老年心房颤动病人抗凝治疗的有效性、安全性。方法 选择符合本研究抗凝标准的132例老年心房颤动病人随机分为两组 ,华法林治疗组 (治疗组 ) 5 8例 ,给予华法林 3mg/ d开始 ,监测凝血酶原时间(PT)及国际标准化比值 (INR) ,7～ 15 d使 INR达到 1.8～ 2 .5范围内 ,以后每月查 1次 INR。若病人增加或减少药物有出血倾向时随时再测 INR。阿司匹林对照组 (对照组 ) 74例 ,给予阿司匹林 30 0 mg/ d,分 2次口服 ,密切随访。结果 治疗组 7～ 15 d,平均 (9.1± 2 .8) d,INR达 1.8～ 3.0 (平均 2 .1± 0 .13) ,其中 INR在 1.8～ 2 .5 (平均 1.92±0 .2 3)之间者占 92 .7% ,治疗组有 1例心瓣膜病人出现脑梗死 ,而对照组有 7例发生脑梗死 ,差异显著 ,其余不良反应率两组差异无显著性。结论 老年心房颤动病人选择华法林 2～ 3mg/ d时 ,加强服药后监测及各药物间的相互作用 ,使 INR保持在 1.8～ 2 .5之间是有效。

Objective To assess the effectiveness and security of wanfarin in treatment of anticoagulation in old patients with chronic atrial fibrillation. Method The patients of chronic atrial fibrillation who were coincidence with ainticoagulation condition were divided into two groups at random, oral wanfarin treatment group and control group. PT and INR of the whole patients were detected, the treatment group were administed 3mg/d dose of warfarin. INR is in the range of 1.8-2.5 after 7-15 days, and from then on, INR were detected every month. When the patients were inclined to hemorrhagia symptom, their INR was detected immediately. The patients of control group were administered aspirin 300mg orally twice a day. Results INR of the treatment group attained to 1.8- 3.0 after 7-15(9.1±2.8) days. It takes 92.7% of the patients in the treatment group whose INR were attained to 1.8-2.5(1.92±0.23). Only one case of the treatment group was found cerebral embolism, while 6 in the control group, there was significant difference. However, there was no any other significant difference in complications. Conclusion 2-3mg dose of oral warfarin in old chronic Af patients with INR in the range of 1.8-2.5 is effetive,safe and convenient.