摘要
目的探讨不同抗栓药物在二级预防高龄非瓣膜性心房颤动脑栓塞的临床效果。方法选择2010年01月至2013年12月在本院住院的高龄非瓣膜性房颤合并血栓栓塞患者165例，所有患者既往均有脑血栓史，按照治疗药物不同，分为华法林组（n=57），氯吡格雷组（n=54）和阿司匹林组（n=54），比较三种药物在预防高龄非瓣膜性心房颤动脑栓塞的作用。结果总危险事件统计华法林组24例（42.1%），氯吡格雷组40例（74.1%），阿司匹林组50例（92.6%），华法林组能显著降低危险事件发生率（P＜ 0.05）；三组脑栓塞复发率和后循环缺血发生率大小比较均为：阿司匹林组 ＞氯吡格雷组 ＞华法林组，三组间均有统计学差异（P＜ 0.05）；与阿司匹林治疗组比较，华法林组和氯吡格雷组的出血事件总发生率显著升高（P ＜ 0.05）；三组间在病死率方面无统计学差异（P ＞0.05）。结论华法林能显著降低总危险事件发生率，在无禁忌证时，对高龄高危脑栓塞患者应首选华法林，若有禁忌证则考虑氯吡格雷或阿司匹林。
Obj ective]To explore clinical efficacy of different antithrombotic drugs for second level pre-vention of senile nonvalvular atrial fibrillation and cerebral embolism.[Methods]Totally 165 senile patients with nonvalvular atrial fibrillation and thromboembolism in our hospital from Jan.2010 to Dec.2013 were en-rolled in the study.All patients had previous history of cerebral thromboembolism.According to different treatment drugs,all patients were divided into warfarin group（n=57）,clopidogrel group（n=54）and aspi-rin group（n=54）.The efficacy of three kinds of drugs in the prevention of senile nonvalvular atrial fibrilla-tion and cerebral embolism was compared.[Results]The total risk events occurred in 24 patients of warfarin group（42.1%）,40 patients of clopidogrel group（74.1%）and 50 patients of aspirin group（92.6%）.Warfarin could significantly reduce the incidence of risk events（P 〈 0.05）.The recurrence rate of cerebral embolism and the incidence rate of transient ischemic attack（TIA）in aspirin group were the highest,and those in clopi-dogrel group and warfarin group were the second and third respectively,and there were significant differences among 3 groups（P〈 0.05）.Compared with aspirin group,the total incidence of bleeding event in warfarin group and clopidogrel group were increased significantly（P〈 0.05）.There was no significant difference in the fatality rate among 3 groups（P〈 0.05）.[Conclusion]Warfarin can significantly reduce the incidence of total risk events.If there is no contraindication,warfarin is the first choice for senile patients with high-risk embol-ism.If there are contraindications,clopidogrel or aspirin should be considered.
出处
《医学临床研究》
CAS
2014年第12期2413-2415,共3页
Journal of Clinical Research
