摘要
目的:研究适宜剂量的华法林对北京市房山区65岁以上老年持久性非瓣膜性房颤(NVAF)患者的疗效。方法:对纳入研究的870例持久性NVAF患者抗凝治疗资料进行回顾性分析。患者被分为阿司匹林组(471例)和调整剂量华法林(维持INR在2.0～3.0)组(369例)。两组在年龄、性别、伴随病等方面无显著差异。比较两组主要、次要终点事件。结果:入选病例共937例,有效病例870例,失访67例(7.1%)。随访时间(19.2±2.1)个月。华法林组主要终点事件(死亡和缺血性脑卒中)较阿司匹林组降低62%(1.06%∶6.52%,P=0.04)。华法林组的缺血性脑卒中较阿司匹林组下降68%(0.42%∶4.76%,P=0.04);华法林组总死亡率低于阿司匹林组(0.42%∶3.00%,P=0.02)。包括主要和次要终点的联合终点事件华法林组低于阿司匹林组(2.97%∶13.03%,P=0.04)。华法林组出血率较阿司匹林组显著减少(1.69%∶12.02%,P=0.04)。结论:对于老年持久性非瓣膜性房颤患者,给予华法林维持INR在2.0～3.0的剂量,可以较阿司匹林更大程度地降低并发症和死亡率,而且是安全的。
Objective：To study the effect of Warfarin by optimal intensity in aged patients with nonvalvular atrial fibrillation （NVAF）in Beijing. Methods：The clinic data of over 65 years old patients with permanent NVAF in Beijing were analyzed. The patients received aspirin 150-160 mg once daily （aspirin group,471 cases）or adjusted-dose[international normalized ratio（INR） 2.0-3.0]Warfarin（Warfarin group, 369 cases）. Follow-up period was （19.2 ± 2.1） months. There was no significant differences between two groups in age,sex and medicine. Results：The mean dose of Warfarin was （3.0±0.3） mg. Compared with aspirin group, the primary end point event（death and ischemic stroke）of Warfarin group significantly reduced 62% （1.06%：6.52%, P〈0. 05） . The rates of ischemic stroke and death （0.42%, 0.42 %） in Warfarin group significantly decreased than those of aspirin group（4. 76 %, 3.00%, P〈0.05）. The combined end point event of Warfarin significantly decreased than that of aspirin group （2.97 % ： 13.03 %, P〈0. 05）. The bleeding rate of Warfarin group was significantly less than that of aspirin group（1.69% ： 12.02 %, P= 0.04）. Conclusion：The adjusted-dose （INR 2.0-3.0）of Warfarin may significantly decrease rates of complication and death, and is safe compared with aspirin for patients with permanent nonvalvular atrial fibrillation.
出处
《心血管康复医学杂志》
CAS
2009年第2期138-141,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心房颤动
华法林
阿司匹林
抗凝药
Atrial fibrillation
Warfarin
Aspirin
Anticoagulants
