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目的:探讨不同抗凝强度华法林应用于非瓣膜性心房颤动患者的可行性及安全性。方法:91例非瓣膜性心房颤动患者随机分为三组:低抗凝强度[国际标准化比率(INR)1.5~1.9];标准抗凝强度组(INR 2.0~2.5)和阿司匹林组,观察三组血栓栓塞并发症和出血等不良反应的发生率以及C-反应蛋白浓度变化。结果:标准抗凝强度组血栓发生率低于低抗凝强度组、阿司匹林组,不同强度华法林抗凝组血栓栓塞率比较差异无统计学意义;标准抗凝强度组出血发生率低于其他两个组,但三组患者出血发生率比较无统计学意义(P>0.05);治疗后低抗凝强度组、标准抗凝强度组C-反应蛋白浓度明显低于治疗前(P<0.05),治疗后阿司匹林组C-反应蛋白水平明显高于低抗凝强度组、标准抗凝强度组(P<0.01)。结论:华法林抗凝维持INR值在2.0~2.5时能降低非瓣膜性房颤患者血栓栓塞发生率,出血发生率低,有效性和安全性好。
Objective: To investigate the feasibility and safety of warfarin with different anticoagulation strength in patients with nonvalvular atrial fibrillation. Methods: Ninety-one patients with non-valvular atrial fibrillation were randomly divided into three groups: low anticoagulant strength (INR 1.5-1.9); standard anticoagulation strength group (INR 2.0-2.5) and aspirin group Incidence of thromboembolic complications and bleeding and other adverse reactions and C-reactive protein concentration changes. Results: The incidence of thrombosis was lower in the standard anticoagulation group than in the low anticoagulation group and aspirin group, but there was no significant difference in the thromboembolism rate between the anticoagulation group and the standard anticoagulation group. The bleeding rate in the standard anticoagulation group was lower than the other two (P> 0.05). After treatment, the concentrations of C-reactive protein in the low anticoagulant group and the standard anticoagulant group were significantly lower than those before treatment (P <0.05), and the rates of hemorrhage in the three groups were not statistically significant Post-aspirin C-reactive protein levels were significantly higher than the low anticoagulant group, the standard anticoagulant group (P <0.01). CONCLUSION: Warfarin can reduce the incidence of thromboembolism in patients with non-valvular atrial fibrillation when the INR value of anticoagulant is 2.0-2.5, the incidence of bleeding is low, and its efficacy and safety are good.