华法林预防非瓣膜病房颤血栓栓塞

目的探讨华法林及适合的INR预防非瓣膜病房颤血栓栓塞.方法将非瓣膜病房颤患者采用随机的方法将206例分为华法林治疗组103例、阿司匹林对照组103例.治疗组采用华法林片,剂型为2.5mg,服用方法为2.5mg/d,用量范围为1.5～5mg/d,服药后每3d复查1次INR,稳定后1个月、6个月、1年复查国际标准化比值(INR),并依据INR调整华法林用量,使INR保持在1.6～2.5之间.对照组采用阿司匹林片,剂型为25mg,100mg/d,1个月、6个月、1年复查国际标准化比值(INR),随访1年.随访两组患者的临床预后情况,包括:血栓栓塞、出血情况.结果血栓栓塞情况:华法林组血栓栓塞发生率为0.98%/年,阿司匹林组为3.96%/年,两组比较差异有统计学意义(P<0.05).出血情况:华法林组发生率为2.94%/年,阿司匹林组1.98%/年,两组比较差异无统计学意义(P>0.05).结论非瓣膜病房颤采用华法林抗凝治疗并注意监测INR,使INR保持在1.6～2.5之间,是安全有效的.

Usage of warfarin to prevent thromboembolism due to atrial fibrillation of non-valves cardiac disease

Objective To study Warfarin and appropriate INR in order to prevent thromboembolism of non-valves cardiac disease.Methods Two hundred and six patients were divided randomly into Warfarin group (treatment group) and Aspirin group (control group) on average. Patients of treatment group were dispensed by Warfarin, the dosage was 2.5mg /d, and the range of dosage was 1.5 - 5mg /d.Then detect the value of INR every 3 days; and 1 month, half year, 1 year after INR was inclined to be stable. According to the value of INR, we adjusted the dosage of Warfarin in order to keep the INR between 1.6 and 2.5. Meanwhile, patients of control group were given Aspirin, the dosage was 100mg/d, then detect the value of INR after 1 month, half year and 1 year. Clinical prognosis of the both groups suc-h as thromboembolism and hemorrhage were followed up.Results The incidence rate of thromboembolism in Warfarin group (0.98%/year) was significantly lower than that in Aspirin group (3.96%/year, P<0.05). And no significant difference was found in the incidence rate of hemorrhage between the Warfarin group and Aspirin group (2.94%/year and 1.98%/year,P>0.05).Conclusion It is safe and effective when using Warfarin to prevent thromboembolism of non-valves cardiac disease, on condition that the value of INR is kept between 1.6 and 2.5.