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目的通过研究比较阿司匹林与调整剂量华法林预防心房颤动(房颤)患者发生血栓栓塞的有效性和安全性。方法根据入选标准房颤患者随机分为阿司匹林组和调整剂量华法林组,常规门诊随访,调整华法林剂量并记录两组患者的终点事件和不良反应发生情况。结果共180例患者进入分析,阿司匹林组90例,华法林组90例。随访3年。与阿司匹林比较,调整剂量华法林明显降低终点事件发生率,华法林组轻微出血高于阿司匹林组。结论与阿司匹林相比,华法林可明显降低房颤患者脑卒中的发生率,但华法林组出血的发生率高于阿司匹林组,多数出血并发症发生在INR>3.0,严密监测(INR 2.0-3.0)下的调整剂量华法林安全有效。
Objective To compare the efficacy and safety of aspirin with adjusted-dose warfarin in preventing thromboembolism in patients with atrial fibrillation (AF). Methods Atrial fibrillation patients were randomly divided into aspirin group and warfarin-adjusted dose group. The patients were followed up routinely. The dosage of warfarin was adjusted and the endpoint events and adverse reactions of both groups were recorded. Results A total of 180 patients were enrolled in the analysis, 90 patients in the aspirin group and 90 patients in the warfarin group. Followed up for 3 years. Compared with aspirin, warfarin dose adjustment significantly reduced the incidence of endpoints, mild bleeding warfarin group than aspirin group. Conclusion Compared with aspirin, warfarin can significantly reduce the incidence of stroke in patients with atrial fibrillation, but the incidence of bleeding in warfarin group was higher than that in aspirin group. The majority of bleeding complications occurred in INR> 3.0 and closely monitored (INR 2.0 -3.0) to adjust the dose of warfarin safe and effective.