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目的评价华法令预防非瓣膜病性心房颤动血栓栓塞的疗效及安全性。方法观察332例具有中高危危险因素的非瓣膜病性心房颤动患者,108例(A组)口服阿司匹林;224例(B组)口服华法令,B组依房颤性质再分为阵发性房颤组(B1亚组)和持续性房颤组(B2亚组),根据国际标准化比值(INR)调整华法令剂量。随访观察脑栓塞、外周血管栓塞、出血、死亡等终点事件。结果 A组终点事件发生率明显高于B组(28.7%vs 15.2%,P<0.01),B1、B2亚组均在第6～9天达到有效抗凝,第12～15天稳定,华法令剂量无显著性差异[(3.16±0.55)mg/d vs(3.18±0.62)mg/d,P>0.05]。结论华法令对非瓣膜病性心房颤动患者预防血栓栓塞安全、可靠。
Objective To evaluate the efficacy and safety of warfarin in preventing non-valvular atrial fibrillation thromboembolism. Methods A total of 332 patients with non-valvular atrial fibrillation who were at risk for middle and high risk were enrolled in the study. A total of 108 patients (group A) received aspirin. 224 patients (group B) received warfarin. Patients in group B were divided into paroxysmal atrial fibrillation (B1 subgroup), and persistent atrial fibrillation (B2 subgroup), warfarin dose was adjusted according to International Normalized Ratio (INR). Follow-up observation of cerebral embolism, peripheral vascular embolism, bleeding, death and other end events. Results The incidence of end point in group A was significantly higher than that in group B (28.7% vs 15.2%, P <0.01). Both B1 and B2 subgroups achieved effective anticoagulation on days 6-9 and remained stable on days 12-15. Warfarin There was no significant difference in dose [(3.16 ± 0.55) mg / d vs (3.18 ± 0.62) mg / d, P> 0.05]. Conclusion Warfarin is safe and reliable in preventing thromboembolism in patients with non-valvular atrial fibrillation.