华法林不同抗凝强度治疗阵发性房颤的对出血并发症的影响

Effect of Different Strength Warfarin Anticoagulant Therapies on Hemorrhagic Complications in Patients with Paroxysmal Atrial Fibrillation

目的分析华法林不同抗凝治疗对阵发性房颤的出血性并发症的影响。方法抽选2014年6月至2015年6月就诊于我院的阵发性房颤患者102例,随机数字表法分为2组,每组51例,两组患者均给予华法林口服治疗,低强度组起始剂量为1.8 mg,根据INR调整用剂量,维持INR值为1.3-2.0;高强度组起始剂量为2.5 mg,根据INR调整剂量,维持INR值为2.1-3.0。统计两组患者复律率和维持窦律率,比较两组患者出血性并发症发生情况。结果两组患者3周内复律率比较(80.39%VS 88.00%)(P>0.05);高强度组维持窦律率与低强度组比较显著较高(74.51%VS 52.94%)(P<0.05)。高强度组与低强度组比较出血性并发症无显著差异(25.49%VS 13.73%)(P>0.05)。结论华法林高强度抗凝治疗阵发性房颤,维持窦律维持效果佳,出血性并发症未显著增加,安全性高。

Objective To analyze the effect of different strength warfarin anticoagulant therapies on hemorrhagic complications in patients with paroxysmal atrial fibrillation. Methods 102 patients with paroxysmal atrial fibrillation who were treated in our hospital between June 2014 and June 2015 were enrolled in the study. According to the random number table method,the patients were divided into 2 groups,51 cases in each group. Both of the two groups were treated with oral warfarin. The initial dose of the low strength group was 1.8 mg. According to INR,the dose was adjusted and the INR value was maintained at 1. 3-2. 0; The initial dose of the high strength group was 2. 5 mg. According to INR,the dose was adjusted and the INR value was maintained at 2. 1-3. 0. The cardioversion rate and sinus rhythm maintenance rate in the two groups were statistically analyzed. The occurrence of hemorrhagic complications was compared between the two groups. Results There was no significant difference in tcardioversion rate in 3 weeks between the two groups( 80. 39% VS 88.00%)( P > 0. 05); The sinus rhythm maintenance rate in the high intensity group was significantly higher than that in the low strength group( 74. 51% VS 52. 94%)( P < 0. 05). There was no significant difference in the incidence of hemorrhagic complications between the high strength group and low strength group( 25. 49% VS13. 73%)( P > 0. 05). Conclusion Warfarin high strength anticoagulant therapy in patients with paroxysmal atrial fibrillation effect in maintaining sinus rhythm is good,and it does not increase hemorrhagic complications significantly. The safety is high.