标题：低强度华法林在非瓣膜性心房颤动脑栓塞高风险患者中的应用

      作者：刘宝堂，敬永强    (汉中市略阳县人民医院心血管内科，陕西 汉中 724300)

      卷次： 2017年28卷2期

      【摘要】 目的 观察低强度华法林在非瓣膜性心房颤动脑栓塞高风险患者中的应用效果和安全性。方法 采用前瞻性研究，选择2015年1~6月在我院心内科住院的非瓣膜性心房颤动脑栓塞高风险患者92例，采用数字表随机法分为两组，A组 46例给予低强度华法林(1.6<国际标准化比值 INR≤2.0)治疗，B组 46例给予标准强度华法林(2.0。结果 A组患者的华法林维持量为(2.5±0.3) mg/d，低于B组的(3.1±0.4) mg/d，平均 INR稳定值为(1.8±0.1)，低于B组的(2.4±0.3)，差异均有统计学意义(P<0.05)；A组患者的 INR首次达标时间为(13.2±3.1) d，长于B组的(11.8±2.9) d，差异有统计学意义(P<0.05)；A组患者的血栓栓塞发生率为4.35%，低于B组的8.70%，但差异无统计学意义 (P>0.05)；A组患者的出血发生率为8.70%，明显低于B组的21.74%，差异有统计学意义(P<0.05)。结论 低强度华法林对非瓣膜性心房颤动患者血栓栓塞的预防作用与标准强度华法林基本相同，但用量明显减少，用药安全性明显提高。
      【关键词】 强度；华法林；非瓣膜性心房颤动；脑栓塞；预防；安全性
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2017）02—0209—02

Application of low intensity warfarin in patients with nonvalvular atrial fibrillation at high risk of cerebralembolism.
LIU Bao-tang, JING Yong-qiang. Cardiovascular Internal Medicine, the People's Hospital of Lueyang County,Hanzhong 724300, Shaanxi, CHINA
【Abstract】 Objective To observe the application effect and safety of low intensity warfarin in patients withnonvalvular atrial fibrillation at high risk of cerebral embolism. Methods Between January 2015 and June 2015, 92 pa-tients with nonvalvular atrial fibrillation at high risk of cerebral embolism in our hospital were randomly divided intotwo groups: 46 patients of group A for low intensity warfarin treatment (group A, 1.6. Results Warfarin dos-age, average INR value in group A were (2.5±0.3) mg/d, (1.8±0.1), which were significantly lower than (3.1± 0.4) mg/d,(2.4 ± 0.3) in group B (P<0.05). Time reaching standard INR for the first time in group A was longer than that in groupB, (13.2±3.1) d vs (11.8 ± 2.9) d, P<0.05. The incidence of thromboembolism in group A (4.35%) was slightly lower thanthat in group B (8.70%), but there was no statistically significant difference (P>0.05). The hemorrhage rate in group Awas 8.70%, significantly lower than 21.74% in group B (P<0.05). Conclusion Low intensity warfarin has similar ef-fect as standard intensity warfarin for preventing cerebral embolism in patients with nonvalvular atrial fibrillation, butthe dosage was significantly reduced and the security was significantly improved.
      【Key words】 Intensity; Warfarin; Nonvalvular atrial fibrillation; Cerebral embolism; Prevention; Security·论 著·doi:10.3969/j.issn.1003-6350.2017.02.012