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目的:探讨不同抗栓药物对阵发性非瓣膜性心房颤动(Paroxysmal nonvalvul aratrial fibrillation,PAF)心、脑及外周血管疾病血栓的预防作用。方法:选取PAF病例807例,其中80例因各种原因失访,有效病例727例,分别使用华法林和阿司匹林进行抗栓治疗,随访心脑血管疾病发生情况,比较二者预防主要终点、次要终点事件、主要出血事件及次要出血事件发生率。结果:高危PAF组,使用华法林治疗主要终点事件及次要终点事件均较阿司匹林组低(P﹤0.05),出血事件二者间无差异(P>0.05);中危PAF组,使用华法林及阿司匹林治疗,二者在主要终点事件及出血事件发生率间无差异(P>0.05),而应用华法林抗凝较应用阿司匹林抗栓能降低次要终点事件、及次要事件(P﹤0.05)。结论:对高危PAF病例,应用华法林抗凝较优于应用阿司匹林抗栓;对中危PAF病例,主要事件二者疗效相当,但应用华法林抗凝能减低次要事件发生率。
Objective: To investigate the preventive effects of different antithrombotic drugs on thrombus in heart, brain and peripheral vascular diseases of paroxysmal nonvalvular atrial fibrillation (PAF). Methods: 807 PAF cases were selected, of which 80 cases were lost due to various reasons. 727 cases were effectively treated with warfarin and aspirin. The incidence of cardiovascular and cerebrovascular diseases were followed up. The main endpoints of both were compared. Secondary end point events, major bleeding events and minor bleeding events. Results: In the high-risk PAF group, the main endpoints and secondary endpoints of warfarin treatment were lower than those of aspirin group (P <0.05), but there was no difference between the two groups (P> 0.05) (P> 0.05). However, the application of aspirin antithrombotics and warfarin anticoagulation can reduce the secondary end point events and secondary events (P < 0.05). CONCLUSIONS: For high-risk PAF cases, warfarin is better than aspirin antithrombotics. For moderate-risk PAF cases, the main events are similar, but warfarin anticoagulation can reduce the incidence of secondary events.