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目的:分析高原红细胞增多症合并房颤患者出现缺血性脑卒中后,因红细胞增高、血红蛋白增高,合并不同程度血小板减少及凝血功能障碍,为进行缺血性脑卒中二级预防给予华法林低强度抗凝治疗,观察用药后的缺血性脑卒中复发率及出血风险。方法:将90例高原红细胞增多症伴有心房纤颤的缺血性脑卒中患者按治疗方法的不同随机分为治疗组和对照组,分别进行使用华法林片低强度抗凝治疗及常规阿司匹林肠溶片抗血小板治疗,观察两组患者治疗后再发缺血性脑卒中及出血(脑出血及消化道出血)的概率,进行比较分析。结果:观察12个月,华法林组缺血性卒中复发率9.30%,出血率4.65%,常规阿司匹林肠溶片治疗组缺血性卒中复发率为27.66%,出血率为4.26%。结论:低强度华法林抗凝治疗,针对高原红细胞增多症合并房颤发生缺血性脑卒中后患者的卒中二级预防,效果明显优于阿司匹林抗血小板治疗,且安全性高。
OBJECTIVE: To analyze the incidence of ischemic stroke in patients with high altitude polycythemia complicated by atrial fibrillation, and to provide warfarin for secondary prevention of ischemic stroke due to the increase of erythrocyte, hemoglobin, thrombocytopenia and coagulation dysfunction. Low-intensity anticoagulant therapy was used to observe the relapse rate of ischemic stroke and bleeding risk after treatment. Methods: 90 patients with platelet polycythemia accompanying atrial fibrillation ischemic stroke patients were randomly divided into treatment group and control group according to different treatment methods, respectively, the use of warfarin low-intensity anticoagulant therapy and conventional aspirin Enteric-coated tablets anti-platelet therapy, observe the probability of ischemic stroke and hemorrhage (cerebral hemorrhage and gastrointestinal bleeding) in the two groups after treatment, and make a comparative analysis. Results: At 12 months, the recurrence rate of ischemic stroke in warfarin group was 9.30% and the bleeding rate was 4.65%. The recurrence rate of ischemic stroke was 27.66% and the bleeding rate was 4.26% in routine aspirin enteric-coated tablets group. CONCLUSIONS: Low-intensity warfarin anticoagulant therapy is effective in secondary prevention of stroke after ischemic stroke in patients with high altitude polycythemia and atrial fibrillation, and is superior to aspirin in antiplatelet therapy with high safety.