华法令对非瓣膜病性房颤患者血栓形成的干预作用

目的　探讨华法令对于非瓣膜病性心房颤动 (NVAF)患者抗凝治疗的临床效果 ,摸索出深圳地区NVAF患者华法令抗凝治疗的有效安全剂量。方法　对符合本研究标准的 74例老年心房颤动患者随机分为华法令治疗组和阿司匹林对照组 ,治疗组 36例 ,给予华法令 3mg d开始 ,监测凝血酶原时间(PT)及国际标准化比值 (INR) ,连续观察 4周使INR在 2 .0～ 3.0范围内 ,以后每月查 1次INR。若患者需增加或减少药物或有出血倾向时随时再测INR ;对照组 38例 ,给予阿司匹林 30 0mg d ,分 2次服用。结果　治疗组PT监测 ,第 1、2、4、8周 ,均较用药前有显著性差异 (P <0 .0 5 ) ;随访期间 ,治疗组脑卒中的发生率为 2 .8% ,对照组为 13.2 % ,两组比较差异有显著性 (P <0 .0 5 ) ;两组均未见明显的出血等不良反应。结论　深圳地区非瓣膜病性心房颤动患者选择华法令 3～ 4mg d抗凝治疗是安全有效的

Assessment of effectiveness and security of warfarin in the treatment of anticoagulation in middle-ageing non-valvular patients with Chronic Atrial Fibrillation

Objective To assess the effectiveness and security of warfarin in the treatment of anticoagulation in middle-ageing non-valvular patients with chronic atrial fibrillation.Methods The patients of chronic atrial fibrillation were divided into two groups randomly warfare group and aspirine group. PT and INR of the whole patients were detected, the warfarin group were administed 3 mg/d dose of warfarin. PT and INR were detected every other day. One week later, the dosage of warfarin was increased to 4 mg/d if INR did not reach 2.0-3.0. INR was detected every other week until it reached about 2.0-3.0. Four weeks later, INR was detected every month. When the patients were inclined to hemorrhagia symptom, their INR was detected immediately. The patients of aspirin group were administered aspirin 300mg orally twice a day. Results In warfarin group, PT was significantly lower than that before treatment, P<0.05; The ratio of cerebral embolism was 2.8% in warfarin group, but it was 13.2% in aspirin group, P<0.05. Conclusions 3-4 mg dose of oral warfarin in chronic Af patients with INR in the range of 1.8-2.5 is effective, safe and convenient.