摘要
目的观察华法林治疗高龄心房纤颤患者的疗效及安全性。方法选取年龄≥80岁高龄老年心房纤颤患者41例,随机分为华法林组(20例)和对照组(21例)。治疗组患者采用华法林抗凝治疗,对照组患者采用阿司匹林治疗。随访3年,比较两组患者脑出血和脑栓塞的发生率。结果随访3年内,治疗组发生脑栓塞1例(5.0%),对照组发生脑栓塞5例(9.3%)、外周动脉栓塞1例(5.0%),两组间差异有统计学意义(χ2=0.119,P<0.05)。两组患者均无严重出血,轻微出血发生率差异无统计学意义。根据危险因素分层后,中危患者血栓栓塞事件治疗组与对照组无统计学意义(χ2=0.847,P>0.05),高危患者治疗组栓塞事件(1例)少于对照组(5例),有统计学意义(χ2=4.102,P<0.05)。结论高危组的高龄老年心房纤颤患者应用华法林抗凝不良反应少、临床疗效满意,值得在临床推广。
Objective To observe the efficacy and safety about warfarin treatment in elderly patients with atrial fibrillation.Methods 41 patients aged more than 80-year-old with atrial fibrillation were selected.20 cases were randomly divided into the treatment group,and 21 cases were randomly divided into the control group.The patients in treatment group were given warfarin to anticoagulation,and the patients in control group were given aspirin instead.The incidence of cerebral hemorrhage and cerebral embolism in the next 3 years were compared between two groups.Results Followed up for 3 years,1 patient（5.0%） in the treatment group and 5 patients（9.3%） in the control group happened cerebral embolism.1 case（5.0%） in the control group happened peripheral arterial thrombosis.The difference between two groups is significant（χ2=0.119,P0.05）.Patients in two groups didn,t happen severe bleeding.The incidence of minor bleeding between two groups was no significant difference.Stratified according to risk factors,the thromboembolic events in middle-risk patients had no significant difference in two groups（χ2=0.847,P0.05）.However,the high-risk patients in control group happened more thrombotic events（5 cases） than that in the treatment group（1 case）.There was a significant difference（χ2=4.102,P0.05）.Conclusion In the high-risk elderly atrial fibrillation patients,warfarin is recommended because of less adverse effects and better clinical effects than aspirin.
出处
《实用心脑肺血管病杂志》
2011年第12期2047-2048,共2页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
作者简介
通讯作者：陈晓琳，210008江苏省南京市，京大学医学院附属鼓楼医院老年科；E—mail：glyycxl@126．com
