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目的探讨高龄心房颤动患者应用调整剂量华法林抗凝治疗的疗效和安全性。方法选择2005年1月-2009年12月在阜阳市人民医院就诊的75例高龄(≥75岁)心房颤动患者,随机分为调整剂量华法林抗凝组(35例)和阿司匹林组(40例),分别给予华法林和阿司匹林治疗,华法林初始剂量2.5mg/d,依INR目标值(2.0～2.5)调整剂量,阿司匹林组给予阿司匹林100mg/d。随访1年,观察两组缺血性脑卒中及出血并发症的发生率。结果华法林组和阿司匹林组缺血性脑卒中发生率分别为5.7%和22.5%,差异有统计学意义(P<0.05)。两组均无严重出血发生,轻微出血发生率分别为8.6%和7.5%,差异无统计学意义(P>0.05)。结论严格控制INR(2.0～2.5)情况下,高龄心房颤动患者应用华法林抗凝治疗安全有效。
Objective To investigate the efficacy and safety of warfarin anticoagulation in elderly patients with atrial fibrillation. Methods A total of 75 elderly patients (≥75 years old) with atrial fibrillation who were treated in Fuyang People’s Hospital from January 2005 to December 2009 were randomly divided into warfarin anticoagulation group (n = 35) and aspirin group (n = 40) , Were given warfarin and aspirin treatment, warfarin initial dose 2.5mg / d, according to INR target value (2.0 ~ 2.5) to adjust the dose, aspirin group given aspirin 100mg / d. Followed up for 1 year, observed the incidence of ischemic stroke and bleeding complications in both groups. Results The incidence of ischemic stroke in warfarin group and aspirin group was 5.7% and 22.5%, respectively, with statistical significance (P <0.05). No severe bleeding occurred in both groups, with mild bleeding rates of 8.6% and 7.5%, respectively, with no significant difference (P> 0.05). Conclusions Strict control of INR (2.0 ~ 2.5), elderly patients with atrial fibrillation warfarin anticoagulant therapy is safe and effective.