【摘要】 目的比较华法林与阿司匹林预防非瓣膜性心房颤动(房颤)患者血栓栓塞的疗效。方法华法林组给药初始剂量为2.0mg/d,调整剂量,使国际标准化比值(INR)稳定在2.0～3.0;阿司匹林组给药剂量为150mg/d。常规门诊随访。主要终点事件为缺血性脑卒中和死亡,次要终点事件包括外周动脉栓塞、短暂性脑缺血发作、无症状脑梗死、急性心肌梗死和严重出血。结果与阿司匹林比较,华法林明显降低主要终点事件发生率(3.3%比10.7%,P<0.05),缺血性脑卒中的相对危险下降69.5%,总血栓栓塞事件相对危险下降71.3%(3.3%比11.5%,P<0.05)。华法林组总出血发生率明显高于阿司匹林组(9.8%比2.5%,P<0.05)。结论华法林能更有效降低非瓣膜性房颤患者血栓栓塞发生率,虽然出血发生率高于阿司匹林组,但严密监测INR,华法林仍然是安全有效的。更多还原

【Abstract】 【Objective】To compare the thromboembolism effect of Warfarin with Aspirin in preventing non-valvular atrial fibrillation (AF) patients. 【Methods】The initial dose of Warfarin group is 2.0 mg/d, and adjusting the dose of warfarin and making the international normalized ratio (INR) stable in the 2.0 ~ 3.0. The dose of Aspirin group is 150 mg/d. AU patients are given conventional out-patient follow-ups. The primary endpoint events are ischemic stroke and death, and secondary endpoint events include peripheral arterial thrombosis, transient ischemic attack, asymptomatic cerebral infarction, acute myocardial infarction and severe bleeding. 【Results】Compared with Aspirin, Warfarin greatly decreased the rate of the primary endpoint events (3.3% vs 10.7%, P <0.05), and ischemic stroke relative risk dropped 69.5 %,and the relative risk of thromboembolism events dropped 71.3% (3.3% vs 11.5%, P <0.05). The total rate of bleeding in Warfarin group was significantly higher than in Aspirin group (9.8% vs 2.5%, P <0.05). 【Conclusions】 Warfarin can effectively reduces the rate of thromboembolism in non-valvular atrial fibrillation patients, although the rate of bleedingis higher than that of Aspirin group. Warfarin is still safe and effective if INR carefully monitored.更多还原