摘要
目的 观察不同抗凝强度的华法林对瓣膜病伴心房颤动 (房颤 )患者血栓栓塞发生的预防效果和安全性。方法 将确诊为二尖瓣狭窄伴房颤患者 197例分为华法林抗凝强度国际标准化比率 (INR) 2 5～ 3 5(中等强度 ,76例 )和INR1 8～ 2 4(低等强度 ,12 1例 )两组 ,给予抗凝治疗。观察两组血栓栓塞并发症及出血等不良反应的发生率。结果 低等强度组血栓栓塞年发生率为 0 55% ,中等强度组为 0 ,两组比较差异无显著性。两组病例中 96%的不良反应为出血 ,低等强度组出血不良反应的年发生率为 7% ,中等强度组为 16% ,两组比较差异有显著性 (P <0 0 5) ,但两组中无一例为严重出血。其他不良反应为皮疹及消化道症状。结论 华法林抗凝强度INR1 8～ 3 5能明显降低瓣膜病伴房颤患者血栓栓塞的发生率 ,其安全性好。INR1 8～ 2 4时有一定的血栓栓塞危险 ,INR2 5～ 3
Objective To observe the safety and prophylactic effect of different anticoagulate intensity of warfarin on the prevention of thrombo-embolism in patients with valvular atrial fibrillation Methods 197 patients with mitral stenosis accompany with atrial fibrillation were studied They were divided into two groups and all took different doses of warfarin The first group′s INR is 2 5-3 5 (middling intensity, 76 patients), the second group′s INR is 1 8-2 4(low intensity, 121 patients) The incidence of the side-effect such as thrombo-embolism and haemorrhagia was compared Results The incidence of thrombo-embolism was 0 55% per annum in the low intensity group compared with 0 % in the middling intensity group, no significant difference was found The main side-effect was haemorrhagia (about 96%), which was 7% per annum in the low intensity group compared with 16% in the middling intensity group, and a significant difference could be found No patient had serious bleeding in these two groups The other side-effect was skin eruption, or digestive tract symptom Conclusions To maintain the INR at 1 8-3 5 with warfarin could reduce the incidence of thrombo-embolism remarkably in patients with valvular atrial fibrillation INR at 1 8-2 4 still have a danger of thrombo-embolism, at 2 5-3 5 a serious bleeding could occur
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2003年第8期597-599,共3页
Chinese Journal of Cardiology
