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目的:探讨口服华法林剂量及适时监测INR值(国际标准化比值,international normalized ratio)以预防非瓣膜病房颤的血栓栓塞。方法:将非瓣膜病房颤病人分为华法林治疗组27例、阿司匹林对照组37例。治疗组口服华法林片,从2.5~3.0mg/d开始,2d后开始每日或隔日检测INR,依据INR调整华法林用量,随访期间使INR保持在1.6~2.5之间。对照组口服阿司匹林片,100mg/d。随访两组病人的血栓栓塞、出血情况。结果:华法林组无血栓栓塞发生,阿司匹林组有5例发生血栓栓塞,两组比较差异有统计学意义(P<0.05)。华法林组有2例轻度出血,阿司匹林组无出血发生,两组比较差异无统计学意义(P>0.05)。结论:非瓣膜病房颤采用华法林抗凝治疗并注意监测INR,使INR保持在1.6~2.5之间,是安全的并能有效防止脑动脉栓塞发生。
Objective: To investigate the oral warfarin dose and timely monitoring INR (international normalized ratio) to prevent thromboembolism in nonvalvular atrial fibrillation. Methods: Non-valvular atrial fibrillation patients were divided into warfarin treatment group 27 cases, aspirin control group 37 cases. The treatment group oral warfarin tablets, starting from 2.5 ~ 3.0mg / d, 2d after the start of daily or every other day to detect INR, adjusted according to INR warfarin dosage, during follow-up to keep INR between 1.6 to 2.5. Control group oral aspirin tablets, 100mg / d. Follow-up two groups of patients with thromboembolism, bleeding. Results: There was no thromboembolism in warfarin group. Thromboembolism was found in 5 patients in aspirin group. There was significant difference between the two groups (P <0.05). There were 2 mild hemorrhages in warfarin group and no bleeding in aspirin group. There was no significant difference between the two groups (P> 0.05). Conclusion: Non-valvular atrial fibrillation with warfarin anticoagulation therapy and pay attention to monitoring INR, INR maintained at between 1.6 to 2.5, is safe and can effectively prevent cerebral arterial embolism.