老年非瓣膜性房颤脑卒中危险分层及抗凝现状分析

目的　对非瓣膜性房颤 (NVAF)脑卒中危险分层及基层医院抗凝现状分析。方法　选择NVAF住院患者 1 2 0例并分成ABC三组 ,分别统计脑卒中发生率 (五年 )。将治疗分a组 (未抗凝 ) ,b、c组 (阿司匹林抗血小板聚集 ) ,d组 (华法林抗凝 )。结果　 1 2 0例中A组脑卒中人数 1 3人 (59.1 % )。B组脑卒中人数 2 2人 (2 9.3 % )。C组 1人 (4.3 % )。A组与B组 ,B组与C组比较有明显差异 (P <0 .0 5)。d组脑卒中发生率为 0 ,明显优于a组。阿斯匹林≥ 1 50mg d(c组 ) ,脑卒中发生人数 3人 (1 2 .5 % ) ,与a组比有明显差异 (P <0 .0 5)。结论　A、B组脑卒中发生率明显高于C组 ,口服华法令及阿斯匹林可降低脑卒中发生率。基层医院对NVAF患者抗凝治疗不充分 ,脑卒中发生率高。

The Risk Stratification of Stroke in Elder Patients with Nonvalvular Atrial Fibrillation and the Status quo of Anticoagulating

Objective To explore the risk stratification of in elder patients with nonvalvular atrial fibrillation (NVAF) and the status quo of anticoagulating in grass roots hospital. Methods 120 patients with NVAF were divided into three groups: A, B and C group, the incidence of stroke was worked out (five years). The patients were divided into 4 groups (a, b, c and d group) received different anticoagulating treatment. Patients in Group a were treated without anticoagulants. Patients in group b and c were taken aspirin orally. Patients in group d were taken anticoagulants warfarin. Results Number of stroke of group A was 13(59.1%), in group B was 22(29.3%), in group C was 1(4.3%). The incidence of Stroke in Group A was higher than in Group B. The incidence of Stroke in group B is higher than in group C (P<0.05). The incidences of stroke of group d and c were lower than in group a (P<0.05). Conclusion Warfarin and Asprin(more than 150mg/d) can lower the incidence of stroke . In grass roots hospital, the anticoagulant is insufficiency and the incidence of stroke is high.