老年非瓣膜病性房颤患者血栓形成干预研究

目的　评价华法林对于老年非瓣膜病性心房颤动患者抗凝治疗的有效性和安全性。方法　对符合本研究标准的 70例老年心房颤动患者随机分为 2组 :华法令治疗组 (A组 )和阿司匹林对照组(B组 ) ,A组 34例 ,给予华法林 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 ;B组 36例 ,给予阿司匹林 30 0mg d ,分 2次服用。结果　华法林治疗组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 12个月 ,在有危险因素的患者中 ,A组脑卒中的发生率为3.4 % ,B组为 13.89% ,两组比较差异有显著性 (P <0 .0 5 )。结论　老年非瓣膜病心房颤动患者选择华法林 3～ 4mg d抗凝治疗 ,使INR保持在 1.8～ 2 .5之间是有效、安全的

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

Objective To assess the effectiveness and security of warfarin in the treatment of anticoagulation in elderly patients with chronic atrial fibrillation.Methods The patients of chronic atrial fibrillation were divided into two groups randomly warfarin group (group A) and aspirine group (group B). PT and INR of the whole patients were detected, the group A 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 group B were administered aspirin 300 mg orally twice a day . Results In group A, PT was significantly lower than that before treatment, P<0.05; IN those patients with risk factor, The ratio of cerebral embolism was 3.4% in group A, but it was 13.89% in group B, P<0.05.Conclusions 2-3 mg dose of oral warfarin in old chronic Af patients with INR in the range of 1.8-2.5 is effective, safe and convenient.