非瓣膜病房颤的华法林抗凝治疗研究

目的：应用华法林对非瓣膜病性心房颤动患者进行抗凝治疗,观察其抗栓疗效和安全性。方法：服用华法林．从3．0mg。1次／d开始．根据血浆凝血酶原时间国际标准化比率（INR）调整华法林剂量．低抗凝强度组患者（46例）INR为1．5～2．1．标准抗凝强度组患者（66例）INR为2．2～3．0．两组均持续服药，随访1～4年．观察有无血栓栓塞事件及出血并发症。结果：低抗凝强度组中有1例发生脑栓塞，当时INR为1．5．栓塞年发生率为2．2％；标准抗凝强度组无栓塞并发症．两组比较差异无显著性（P〉0．05）。服用华法林期间．低抗凝强度组1例肉眼血尿，出血年发生率为2．2％；标准抗凝强度组发生皮肤黏膜出血4例．牙龈出血3例，球结膜出血1例．出血年发生率为12％。当时的INR除3例为〉3．其余均在2．6～3．0之间，未发生严重大出血．低抗凝强度组出血发生率显著低于标准抗凝血组（P〈0．05）。结论：房颤患者华法林抗凝目标INR值在1．5-3．0安全有效。

Anticoagulant therapy of Warfarin in patients with no-valvular heart disease and atrial fibrillation

Objective： To study the effect of anticoagulant therapy of Warfarin in patients with no-valvular heart disease and atrial fibrillation. Methods： A total of 112 patients with no-valvular heart disease and atrial fibrillation were treated with Warfarin and randomly divided into two groups：Low anticoagulation intensity group（INR of plasma prothrombin time was 1.5-2.1） and standard anticoagulation intensity group（INR of plasma prothrombin time was 2.2-3.0）. Follow-up time was 1-4 years. Results：Incidence rate of year for embolism was 2.2%, and incidence rate of year for hemorrhage was 2.2 % in low antieoagulation intensity group. No embolism, and incidence rate of year for hemorrhage was 2.2 % in low anticoagulation intensity group. No embolism generated but incidence rate of year for hemorrhage was 12% in standard anticoagulation intensity group. There was no significant difference in incidence rate of year for embolism between two groups （P〉0.05）, but incidence rate of year for hemorrhage in standard anticoagulation intensity group was more than that of low anticoagulation intensity group（P〈0.05）. Conclusion： The target value of INR of plasma prothrombin time for Warfarin therapy in 1.5-3.0 is suitable for decrease embolism and hemorrhage.