摘要
目的探讨抗栓治疗在低危、中危非瓣膜性房颤(NVAF)中的疗效。方法选取2010年2月至2014年6月期间收治的128例NVAF患者为研究对象。根据CHA2DS2-VASc评分将其分为低危组(62例,CHA2DS2-VASc评分为0分)和中危组(66例,CHA2DS2-VASc评分为1分)。将低危组62例患者随机分为安慰剂组(A组,30例)和阿司匹林组(B组,32例)。将中危组66例患者随机分为阿司匹林联合氯吡格雷组(C组,32例)和华法林组(D组,34例)。评价四组患者血栓栓塞事件、出血事件发生情况。结果 A组和B组、C组和D组患者发病原因构成无明显差异(P>0.05)。A组、B组、C组、D组患者心功能均以NYHA I级为主,四组在心功能方面无明显差异(P>0.05)。A组、B组、C组、D组患者不良反应及出血时国际标准化比值(INR)均无明显差异(P>0.05)。A组和B组患者脑卒中、短暂性脑缺血发作、血栓栓塞发生率无明显差异(P>0.05)。C组和D组患者脑卒中发生率无明显差异(P>0.05),但C组短暂性脑缺血发作发生率高于D组(χ2=4.3453,P=0.0371),C组血栓栓塞发生率高于D组(χ2=5.5479,P=0.0185)。结论阿司匹林对预防低危NVAF患者血栓栓塞事件无明显影响。华法林可减少中危NVAF患者血栓栓塞事件发生风险,且并未明显增加患者出血风险。
Objective To investigate the effect of antithrombotic therapy in the low - risk and intermediate - risk non - valvular atrial fi-brillation（NVAF）. Methods One hundred twenty - eight NVAF patients treated in our hospital during Feb. 2010. ~ Jun. 2014 were selected for the study. According to CHA2DS2 - VASc score,128 patients were divided into low - risk group（62 cases,CHA2DS2 - VASc score was 0） and intermediate - risk group（66 cases,CHA2DS2 - VASc score was 1）. Patients in low - risk group were further randomly divided into place-bo group（group A,30 cases）and aspirin group（group B,32 cases）. Patients in intermediate - risk group were further randomly divided into combined clopidogrel and aspirin group（group C,32 cases）and warfarin group（group D,34 cases）. The occurrence of hemorrhagic and throm-boembolic events in the 4 groups were evaluated. Results There was no difference in the causes of the disease between group A and group B（ P﹥ 0. 05）and between group C and group D（ P ﹥ 0. 05）. There was no difference in the cardiac function（patients were mainly NYHA I）,inci-dence of adverse reaction,and international normalized ratio（INR）among 4 groups（all P ﹥ 0. 05）. No differences were found in the incidences of stroke,transient ischemic attack,and thrombus embolism between group A and group B（ P ﹥ 0. 05）. Although no difference in the incidence of stroke between group C and group D（ P ﹥ 0. 05）,the incidences of transient ischemic attack and thromboembolism of group C were higher than group D（χ^2= 4. 3453,P = 0. 0371;and χ^2= 5. 5479,P = 0. 0185,respectively）. Conclusion Aspirin has no obvious effect on prevention of thromboembolic events in patients with low - risk NVAF. Warfarin can reduce the risk of thromboembolism in intermediate - risk NVAF patients, but not significantly increase the risk of bleeding.
出处
《临床和实验医学杂志》
2015年第2期111-114,共4页
Journal of Clinical and Experimental Medicine
关键词
非瓣膜性房颤
抗栓治疗
血栓栓塞
出血事件
Non - valvular atrial fibrillation
Antithrombotic therapy
Thromboembolism
Bleeding event
