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目的观察长期应用华法林低强度抗凝治疗高龄非瓣膜病性心房颤动(NVAF)患者的疗效及安全性。方法入选2007年1月~2009年6月期间于陆军总医院治疗的NVAF患者115例,其中男性93例,女性22例。所有患者依据年龄分为高龄老年组(58例,≥80岁)和老年组(57例,65~79岁)。所有患者用药前查血常规、肝肾功能、凝血功能、国际标准化比值(INR)等,均口服华法林,初始剂量为2.5mg/d,采用低强度抗凝,目标INR l.6~2.5,依据INR调整华法林剂量。随访5年,记录达到目标INR的华法林用量和药物的不良反应情况。结果连续监测5年,两组患者达到目标INR稳态的华法林用量比较,差异无统计学意义(P>0.05)。两组INR比较,差异无统计学意义(P>0.05)。所有患者均无急性脑梗死发生。两组不良反应发生率比较(17.2%vs.12.3%),差异无统计学意义(P>0.05)。结论严密监测国际标准化比值下,高龄老年NVAF患者应用华法林抗凝治疗,国际标准化比值控制在1.6~2.5是安全有效的。
Objective To observe the long-term use of warfarin low-intensity anticoagulation in elderly patients with non-valvular atrial fibrillation (NVAF) efficacy and safety. Methods A total of 115 NVAF patients were enrolled in the Army General Hospital from January 2007 to June 2009, including 93 males and 22 females. All patients were divided into advanced age group (58 cases, ≥80 years old) and elderly group (57 cases, 65-79 years old) according to their age. All patients were checked for blood routine, liver and kidney function, blood coagulation function, international normalized ratio (INR) and so on. All patients were given warfarin orally. The initial dose was 2.5mg / d, and low-intensity anticoagulation was used. The target INR was 1.6 ~ 2.5 , Adjusted warfarin dose according to INR. After 5 years of follow-up, the amount of warfarin used to achieve the target INR and adverse drug reactions were recorded. Results The continuous monitoring of 5 years, the two groups of patients to achieve target INR steady-state warfarin dosage comparison, the difference was not statistically significant (P> 0.05). There was no significant difference in INR between the two groups (P> 0.05). All patients had no acute cerebral infarction. Adverse reactions between the two groups (17.2% vs.12.3%) showed no significant difference (P> 0.05). Conclusion Closely monitoring the international standardization ratio, elderly elderly patients with NVAF warfarin anticoagulant therapy, the international standardization ratio of 1.6 to 2.5 is safe and effective.