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【摘要】 目的 比较华法林和阿司匹林用于永久性房颤患者抗凝治疗的有效性及安全性。方法 入选符合本研究标准的141例永久性房颤患者,随机分为两组,华法林组(治疗组)70例,以华法林2.5 mg/d作为起始剂量,阿司匹林组(对照组)71例,阿司匹林100 mg/d,早饭后即刻服用。结果 治疗组发生出血3例(4.29%),脑梗死2例(2.82%),上腹不适1例(1.43%)。对照组发生出血2例(2.82%),脑梗死13例(18.31%),上腹不适15例(21.13%)。治疗组脑梗死、上腹不适的发生率低于对照组(P0.05)。结论 华法林抗凝治疗可明显减少栓塞事件及上腹部不适的发生率,INR维持在2.0~3.0之间,用药既有效又安全。
【关键词】房颤; 华法林;阿司匹林;国际标准化比值(INR)
Efficacy and safety of warfarin and Aspirin in permanent atrial fibrillation
WU Rong-hui.Department of Cardiology,The State Farms Hospital of Maoming,Guangdong Province,Maoming 525200,China
【Abstract】 Objective To compared the eff icacy and safety of warfarin and aspirin in the trea-tmen t of atrial fibrillation.Methods 141 cases of patients with permanent atrial fibrillation were divid-ed in to warfarin group(n=70)and aspirin group(n=71)randomly.Warfarin group received warfarin 2.5 mg per day,Adjust the dose according to INR,each dosage 0.5 mg,keep the INR between 2.0 to 3.0,Asp-irin group received aspirin 100 mg per day.Follow-up period was one year.Results Hemorrhage of warfarin group and aspirin group was 4.29%and 2.82%respectively(P>0.05).Cerebral infarction of warfarin group and aspirin group was 2.82%and 18.21%respectively(P 1.4 统计学方法 采用SPSS11.5统计软件,组间比较采用χ�2检验,P4.25652.44 ±0.35
2.2 两组病例不良反应发生情况比较 两组均有轻微出血的不良反应,无严重出血。轻微出血:华法林组3例(4.29%),阿司匹林组2例(2.82%);上腹不适:华法林组1例(1.43%),阿司匹林组15例(21.13%)。即华法林组上腹不适较阿司匹林组发生率明显降低(P0.05),见表2。
表2
治疗组与对照组不良反应的发生情况(例)
组别微/少量出血大量出血上腹不适总发生例数总发生率(%)
华法林组(n=70)301�※45.71
阿司匹林组(n=71)20151723.94
注:与对照组比较,�※P0.05),见表3 。
表3
两组患者治疗后栓塞和出血发生情况(例,%)
组别例数栓塞事件出血事件左房附壁血栓
华法林组低危亚组261(3.85)�※1(3.85)0(0)
中高危亚组442(4.55)��※※�2(4.55)0(0)
阿司匹林组低危亚组273(11.11)1(3.70)0(0)
中高危亚组4412(27.27)1(2.27)1(2.27)
注:与阿司匹林组中低危亚组比较,�※P
