【摘要】 目的　观察心房颤动并心力衰竭患者抗凝治疗的安全性。方法　将心房颤动患者2 92例按心功能分为心衰组(心功能Ⅱ～Ⅳ级,169例)和对照组(心功能Ⅰ组,12 3例)。再按抗凝强度分为中等强度亚组(INR 2 5～3 5 ,心衰组81例,对照组64例)和低等强度亚组(INR 1 8～2 4,心衰组88例,对照组5 9例)。常规抗凝治疗,观察血栓栓塞发生率及出血等不良反应发生率。结果　低等强度抗凝亚组血栓栓塞年发生率为0 61% ,中等强度抗凝亚组血栓栓塞发生率为0。心衰组中,中等强度抗凝亚组出血年发生率为2 0 % ,低等强度抗凝亚组年发生率为8% ,两亚组比较,差异有统计学意义(P <0 . 0 5 ) ;对照组中,中等强度抗凝亚组出血年发生率为13 % ,低等强度抗凝亚组出血年发生率为6% ,两亚组比较,差异有统计学意义(P <0. 0 5 )。心衰组中等抗凝亚组与对照组中等抗凝亚组比较,差异有统计学意义(P <0 . 0 5 )。结论　心房颤动并心力衰竭抗凝治疗是安全有效的。但起始剂量宜小,INR控制在1 8～2 4为宜,当出现心力衰竭加重时,应及时调整华法林剂量,以保证抗凝效果,防止出血并发症发生。更多还原

【Abstract】 Objective To observe the safety in treatment of anticoagulation in patients with atrial fibrillation Combined with heart failure. Methods 292 patients with atrial fibrillation were divided into two groups.The groups of heart failure(cardiac functional class Ⅱ～Ⅳ,169 patients),the groups of control(123 patients with,cardiac functional class).The groups of heart failure and Control were divided into two classes,medium intensity(INR 2.5～3.5,81 patients of heart failure,64 patients of Control),low intensity(INR 1.8～2.4,88 patients of heart failure,59 patients of contrast),and treatment of anticoagulation.The incidence of thrombo-embolism and haemorrhagia was compared. Results The incidence of thrombo-embolism was 0.61% per annum in the low intensity compared with 0% in the medium.In the heart failure groups the incidence of haecmorrhagia was 20% per annum in the medium intensity compared with 8% in the low intensity,with significant difference.The incidence of haemorrhagia in groups of Control was 13% per annum in the medium intensity compared with 6% in the low intensity,with significant difference. Conclusions The anticoagulation treatment in patients with atrial fibrillation and heart failure are of safe and effectiveness.更多还原