【摘要】 目的评估脉血康联合低抗凝强度华法林与阿司匹林治疗非瓣膜性房颤老年患者急性脑梗死的疗效及安全性。方法非瓣膜性房颤伴发急性脑梗死老年患者64例,随机分为2组,每组32例。所有患者均给予基础治疗,对照组予阿司匹林0.1 g,口服,1次/d;治疗组给予脉血康胶囊0.75 g,口服,3次/d,72 h后开始予华法林1.25 mg,口服,1次/d。疗程均为4周。观察2组神经功能缺损评分(NIHSS)、总有效率、凝血功能、血液流变学指标及不良反应。结果 2组治疗后NIHSS变化及总有效率均较治疗前差异有统计学意义(P<0.05)。2组治疗后血液流变学指标及FIB差异有统计学意义(P<0.05)。治疗组治疗后凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)均较治疗前延长,治疗后INR达到低抗凝强度(1.65±0.16),差异有统计学意义(P<0.05)。2组不良反应事件发生率比较差异有统计学意义(P<0.05)。结论与阿司匹林治疗比较,脉血康胶囊联合低抗凝强度华法林治疗非瓣膜性房颤老年患者急性脑梗死有效且安全。更多还原

【Abstract】 Objective To evaluate the therapeutic effect and safety of combined therapy of Maixuekang capsule and low-intensity-anticoagulation warfarin with aspirin on acute cerebral infarction in elderly patients with non-valvular atrial fibrillation. Methods Sixty-four elderly patients with non-valvular atrial fibrillation who were diagnosed as acute cerebral infarction were divided into treatment group( n = 32) and control group( n = 32). All the patients were treated with routine therapy,besides the patients in control group were given aspirin( Bayaspirin 0. 1g po qd),however,the patients in treatment group were given Maixuekang capsule( 0. 75 g po tid) immediately and warfarin( 1. 25 mg po qd) 72 hours later,with a treatment course of 4 weeks for both groups. The changes of NIHSS,total effective rate,blood coagulation function,hemorheological indexes and adverse reactions were observed after treatment for both groups. Results After treatment,there were significant differences in NIHSS and total effective rate for both groups,as compared with those before treatment( P <0. 05). Moreover,there were significant differences between the two groups( P < 0. 05). After treatment,there were significant differences in hemorheological indexes and FIB in both groups,as compared with those before treatment( P < 0. 05). After treatment the PT,TT,APTT in treatment group were obviously prolonged,and INR was increased by 1. 65 + 0. 16,there were significant differences between two groups( P < 0. 05),so were in the incidences of adverse reactions between two groups( 9. 38% vs 21. 9%,P < 0. 05). Conclusion The combined therapy of Maixuekang capsule with low anticoagulation intensity of warfarin is superior to aspirin in treatment of acute cerebral infarction in elderly patients with non-valvular atrial fibrillation,with good therapeutic effects and safety.更多还原