目的评价1例扩张性心肌病重度心衰患者的抗凝治疗方案。方法查阅文献及指南,综述窦性心律重度心衰患者抗凝处理方案。结果临床药师参与药物治疗,制定合理的抗凝治疗方案。结论应充分评估重度心衰患者的心脑血管事件风险及出血风险,个体化制定抗凝治疗策略。 Objective To evaluate the anticoagulant therapy in one patient with severe heart failure with dilated cardiomyopathy. Methods Reference literature and guidelines, review of anticoagulant treatment of patients with severe sinus rhythm heart failure. Results Clinical pharmacists involved in drug treatment, develop a reasonable anticoagulant regimen. Conclusion The risk of cardiovascular and cerebrovascular events and the risk of bleeding should be fully evaluated in patients with severe heart failure, and the anticoagulation strategy should be formulated individually.