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目的回顾性分析华法林在老年房颤患者中的抗凝疗效及安全性。方法选择36例年龄≥65岁房颤患者,在常规治疗的基础上,加服华法林随访观察2年,国际标准化比值(INR)保持在2.0～3.0。将服用华法林坚持2年者19例作为治疗组,另外未能坚持服用华法林者17例为对照组。比较两组间栓塞事件发生率、出血率。结果治疗组失访1例,观察期间无一例出现栓塞并发症,出血并发症3例(占16.7%),均为小量出血;对照组栓塞并发症3例(占17.6%),无出血并发症。对照组栓塞并发症与治疗组比较差异有统计学意义(P<0.05)。治疗组出血患者停用或减少华法林用量使INR保持在2.0～3.0,未再发生出血现象,能继续服药。结论老年房颤患者在合理监测INR情况下应用华法林预防栓塞并发症安全有效。
Objective To retrospectively analyze the anticoagulation efficacy and safety of warfarin in elderly patients with atrial fibrillation. Methods Thirty-six patients with atrial fibrillation aged ≥65 years were selected. On the basis of routine treatment, warfarin plus 2-year follow-up was observed. The international normalized ratio (INR) remained at 2.0-3.0. 19 patients who took warfarin for 2 years as the treatment group and 17 patients who did not insist on taking warfarin as the control group. The incidence of embolic events and the rate of bleeding were compared between the two groups. Results In the treatment group, 1 patient was lost to follow-up, none of the patients had embolic complications during the observation period, and 3 patients (16.7%) had bleeding complications. All of them were small hemorrhage. In the control group, embolism complication occurred in 3 patients (17.6%) without bleeding disease. There was significant difference in embolism complication between the control group and the treatment group (P <0.05). Bleeding patients in the treatment group to disable or reduce the amount of warfarin to maintain INR 2.0 to 3.0, no recurrence of bleeding, can continue to take medicine. Conclusion Warfarin is effective and safe in the prevention of embolization complications in elderly patients with atrial fibrillation under reasonable INR.