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目的评价华法林用于心房颤动患者抗凝治疗的效果与安全性。方法选择符合研究标准的223例房颤患者,随机分为华法林治疗组112例与阿司匹林对照组111例。治疗组给于华法林片,每次2.5 mg,第1天每天3次,第2天每天2次,然后每天1次,治疗开始每2天复查1次国际标准化比值(INR)。稳定后每月复查1次INR,依据INR调整华法令用量,使INR保持在2.0～3.0。对照组给予阿司匹林50 mg,每天3次。每2周进行1次随访,随访期为1年,观察血栓栓塞事件及有无出血情况。结果华法令组的栓塞发生率为1.8%,阿司匹林组为4.58%,两组比较差异有统计学意义(P<0.05);华法令组出血发生率为3.6%,阿司匹林组为1.83%,两组比较差异无统计学意义(P>0.05)。结论心房颤动患者使用华法林抗凝治疗,使INR保持在2.0～3.0,能有效的预防血栓栓塞事件的发生,不良反应轻微,临床用药安全。
Objective To evaluate the efficacy and safety of warfarin in anticoagulant therapy in patients with atrial fibrillation. Methods A total of 223 patients with atrial fibrillation who met the criteria of the study were randomly divided into warfarin treatment group (112 cases) and aspirin control group (111 case). The treatment group was given warfarin tablets 2.5 mg each time, three times daily on day 1, twice daily on day two and then once daily. International standardization ratios (INRs) were reviewed every two days beginning of treatment. Once a month, once a month, check the INR and adjust the amount of warfarin according to the INR so that the INR stays at 2.0 to 3.0. The control group was given aspirin 50 mg three times a day. Follow-up was performed every two weeks for one year. Thromboembolism events and bleeding were observed. Results The incidence of embolism was 1.8% in warfarin group and 4.58% in aspirin group, with significant difference between the two groups (P <0.05). The incidence of bleeding in warfarin group was 3.6% and in aspirin group was 1.83% The difference was not statistically significant (P> 0.05). Conclusion Atrial fibrillation in patients with warfarin anticoagulant therapy, INR maintained at 2.0 to 3.0, can effectively prevent the occurrence of thromboembolic events, minor adverse reactions, clinical drug safety.