华法林预防非瓣膜性心房颤动患者血栓栓塞的临床研究

目的探讨简化抗凝指标检测法及低抗凝强度华法林应用于非瓣膜性心房颤动患者的可行性。方法108例非瓣膜性心房颤动患者随机分为低抗凝强度[国际标准化比率(INR)1.6~2.0]和标准抗凝强度组(INR2.1~3.0),服用华法林后第3天采血检测INR,以后每周至每月检测1次,观察两组血栓栓塞并发症及出血等不良反应的发生率。结果106例患者第3天检测INR≤3.0,2例INR>3.0;平均随访2.9年,低抗凝强度组栓塞年发生率0.62%,标准抗凝强度组未发生栓塞,但两组比较差异无统计学意义(P>0.05);出血年发生率分别为1.23%和7.96%,两组比较差异有统计学意义(P<0.05)。结论应用简化抗凝检测方法是可行的,对非瓣膜性心房颤动患者可考虑应用低抗凝强度华法林治疗。

Clinical study of warfaren in prevention of thrombo-embolism in patients with nonvalvular atrial fibrillation

Objective To explore the feasibility to use simplified anticoagulate index testing method and low anticoagulate intensity warfarin in patiens with nonvalvular atrial fibrillation(AF). Methods One hundred and eight patients with nonvalvular AF were retrospectively studied.They were divided into two groups: low anticoagulate intensity group [international normalized ratio(INR) 1.6~2.0] and standard anticoagulate intensity group(INR2.1~3.0).INR was tested on the 3th day after beginning taking warfaren,and tested once a week to once a month later.The incidence of thrombo-embolism and haemorrhagia were recorded and compared. Results On the 3th day,98.2% of all patients had INR ≤3.0.Mean follow-up period was 2.9 years.The annual incidence of throbo-embolism was 0.62% in low intensity group and 0% in standard intensity group with no statistically significant difference found between these two groups(P>0.05),The annual incidence of haemorrahagia in low intensity group was significantly lower than in standard intensity group(1.23% vs.7.96%,P<0.05). Conclusions The simplified anticogulate index testing method is feasible.Patients with nonvalvular AF can be treated with low anticoagulate intensity warfarin.