对380例非瓣膜病性房颤抗栓治疗的调查与分析

收集2014年1月至2016年12月间入住苏州大学附属第一医院的380例非瓣膜病性房颤（NVAF）患者的病历资料。通过卒中和出血风险评估制定抗栓治疗方案，作基因型检测和国际标准化比值（INR）监测等，并对未抗凝治疗的原因进行分析。结果显示，NVAF患者的总体抗凝率为61.84%，其中CHA2DS2-VASc评分≥2分的抗凝率为63.33%，在289例抗栓治疗的患者中，有59.52%选择华法林抗凝，21.80%选择达比加群酯抗凝；172例华法林抗凝的患者出院时INR的达标率为22.09%，行CYP2C9和VKORC1基因型检测的患者其INR达标率（40.74%）明显高于未检测者。

Analysis of Antithrombotic Treatment in Patients with Non-valvular Atrial Fibrillation in Cardiovascular Department of Our Hospital

A total of 380 patients with non-valvular atrial fibrillation (NVAF) in the Cardiovascular Department of the First Affiliated Hospital of Soochow University from January 1, 2014 to December 1, 2016 were retrospectively collected. Stroke and bleeding risk assessment, genotyping and international standardized ratio (INR) were checked and reasons for non-antithrombotic treatment were analyzed. The total rate of anticoagulant treatment was 61.84%, and the rate for patients with CHA2DS2-VASc score over 2 was 63.33%. Of the 289 patients with antithrombotic therapy, 59.52% and 21.80% were given warfarin and dabigatran, respectively. Among the 172 cases with warfarin, 22.09% of the patients reached INR target range. Patients with CYP2C9 and VKORC1 genetic testing had a significantly higher rate of targeted INR.