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华法林对老年2型糖尿病合并心房颤动患者的效果观察

Effect of warfarin on elderly patients with type 2 diabetes complicated with atrial fibrillation
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摘要 目的:观察华法林对老年2型糖尿病合并心房颤动(房颤)患者抗凝治疗的效果。方法:选择132例75岁以上2型糖尿病合并房颤患者,随机分为华法林中等强度组[国际标准化比值(INR)维持在2.1-2.5],华法林低等强度组(INR维持在1.5-2.0),对照组(口服阿司匹林),每组44例。随访1年,记录血栓栓塞和出血事件发生率。结果:华法林中等强度组、低等强度组和对照组血栓栓塞事件呈逐渐增多,对照组血栓栓塞发生率高于华法林中等和低等强度组(P〈0.05),中等和低等强度组血栓栓塞发生率差异无统计学意义(P〉0.05)。中等强度组、低等强度组和对照组出血事件呈逐渐减少,中等强度组出血发生率均高于低等强度组和对照组(P〈0.05),但对照组出血发生率与低等强度组差异无统计学意义(P〉0.05)。结论:华法林治疗老年2型糖尿病合并房颤患者,INR维持在1.5-2.0,不仅能够取得最佳的抗凝效果,同时能够有效地避免出血事件的发生。 Objective: To observe the anticoagulant effect of warfarin in the treatment of elderly patients with type 2 diabetes complicated with atrial fibrillation. Methods: One hundred and thirty-two diabetic patients complicated with atrial fibrillation with the age over 75 were divided into warfarin moderate intensity group[international normalized ratio( INR) was maintained at 2. 1- 2. 5 ],warfarin low intensity group INR was maintained at 1. 5- 2. 0 and control group( aspirin),each group consisting of 44 cases. All the cases were followed up for 1 year. The incidence of thromboembolism and bleeding events were recorded. Results: The incidence of thromboembolic events tended to increase in the moderate intensity group,low intensity group and control group; the incidence of thromboembolism in the control group was higher than that in the warfarin moderate intensity group and low intensity group( P〈0. 05);the difference in the thrombembolia rate had no statistical significance between the moderate intensity group and the low intensity group( P〉0. 05). The bleeding events tended to reduce in the moderate intensity group,low intensity group and control group; the bleeding rate of the moderate intensity group was higher than that of the low intensity group and the control group( P〈0. 05); but the bleeding rate in the control group had no statistical significance compared with that in the low intensity group( P〉0. 05). Conclusions: warfarin is effective on senile diabetic patients complicated with atrial fibrillation when the INR value is maintained at 1. 5- 2. 0,which may achieve the best anticoagulant effect and avoid the occurrence of bleeding events.
作者 宋莹莹
出处 《蚌埠医学院学报》 CAS 2014年第11期1505-1507,共3页 Journal of Bengbu Medical College
关键词 糖尿病 2型 心房颤动 华法林 diabetes mellitus type 2 atrial fibrillation warfarin
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