论文部分内容阅读
目的 观察不同抗凝强度的华法林对瓣膜病伴心房颤动 (房颤 )患者血栓栓塞发生的预防效果和安全性。方法 将确诊为二尖瓣狭窄伴房颤患者 197例分为华法林抗凝强度国际标准化比率 (INR) 2 5～ 3 5(中等强度 ,76例 )和INR1 8～ 2 4(低等强度 ,12 1例 )两组 ,给予抗凝治疗。观察两组血栓栓塞并发症及出血等不良反应的发生率。结果 低等强度组血栓栓塞年发生率为 0 55% ,中等强度组为 0 ,两组比较差异无显著性。两组病例中 96%的不良反应为出血 ,低等强度组出血不良反应的年发生率为 7% ,中等强度组为 16% ,两组比较差异有显著性 (P <0 0 5) ,但两组中无一例为严重出血。其他不良反应为皮疹及消化道症状。结论 华法林抗凝强度INR1 8～ 3 5能明显降低瓣膜病伴房颤患者血栓栓塞的发生率 ,其安全性好。INR1 8～ 2 4时有一定的血栓栓塞危险 ,INR2 5～ 3 5时有一定的严重出血危险性
Objective To observe the preventive effect and safety of warfarin with different anticoagulation intensity on thromboembolism in valvular disease with atrial fibrillation (AF). Methods One hundred and ninety-seven patients with mitral stenosis and atrial fibrillation were divided into two groups according to the international normalized ratio (INR) 25 to 35 (moderate intensity, 76 cases) and INR 18 to 24 (low intensity, 12 1 case) two groups, given anticoagulant therapy. The incidence of thromboembolism complications and bleeding and other adverse reactions were observed. Results The annual incidence of thromboembolism in low-intensity group was 0 55%, while it was 0 in moderate-intensity group. There was no significant difference between the two groups. Ninety-six percent of the adverse reactions in both groups were hemorrhagic, with a 7% incidence of bleeding-related adverse reactions in the low-intensity group and 16% in the moderate-intensity group, with significant differences between the two groups (P <0.05) None of the two groups had severe bleeding. Other adverse reactions were rash and gastrointestinal symptoms. Conclusion The warfarin anticoagulant INR1 8 ~ 3 5 can significantly reduce the incidence of valvular disease with atrial fibrillation in patients with thromboembolism, its safety is good. INR1 8 ~ 2 4 when there is a certain risk of thromboembolism, INR2 5 ~ 3 5 have some serious bleeding risk