心房颤动住院患者抗凝治疗的回顾分析研究

目的通过对280例房颤住院患者的病历资料进行回顾性分析,旨在评价房颤患者的抗凝治疗情况。方法对我院2000年4月-2007年2月出院诊断为持续性房颤的280例患者的住院资料进行详细登记及回顾性总结,建立患者的数据库,利用SPSS软件进行分析。结果应用阿司匹林抗血小板治疗83例,发生脑栓塞14例(16.86%)。用华法林抗凝治疗的患者197例,发生脑栓塞8例(4.06%)(P<0.05),提示华发林抗凝治疗的脑卒中患者患病率低于应用阿司匹林的抗血小板治疗的患者。口服华发林过程中出现出血事件为21例,进行Logistic回归分析,结果提示与口服华发林相关的出血高危因素为慢性肝病,收缩压>160mmHg,年龄>70岁。结论华法林抗凝治疗优于阿司匹林的抗血小板治疗。口服华发林危险因素为慢性肝病,收缩压>160mmHg,年龄>70岁,单纯监测INR是不够的。

Retrospective Study on Anticoagulation Therapy of Inpatients With Atrial Fibrillation

Objective To analyze the clinical data of inpatients with atrial fribrillation(AF)and to evaluate anticoagulation therapy.Methods A total of 280 inpatients with persistent AF from April,2000 to Feburary,2007 were enrolled in this study.Results The prevalence of stroke was 16.86% in the 83 patients with asprin anticoagulation therapy;while the prevalence of stroke was 4.06% in the 197 patients with warfarin therapy.There was a significant difference in the stroke incidence between the two groups(P<0.05).The incidence of hemorrhage was 21 cases with warfarin therapy.Logistic regression analysis showed that the warfarin related high risk factors were chronic hepatic disease,systolic pressure >160mmHg and age>70 in addition to INR.Conclusion Warfarin therapy is superior to that of asprin anticoagulation therapy.Chronic hepatic desease,systolic pressure >160 mmHg and age>70 are all risk factors of bleeding complications with warfarin therapy,and only monitoring INR is insufficient.