中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
4期
461-463
,共3页
华法林%阿司匹林%心力衰竭%心房颤动,持续性
華法林%阿司匹林%心力衰竭%心房顫動,持續性
화법림%아사필림%심력쇠갈%심방전동,지속성
Warfarin%Aspirin%Heart failure%Atrial fibrillation%Permanence
目的:探讨华法林和阿司匹林在重度心力衰竭合并持续性心房颤动(AF)抗栓治疗中的临床疗效。方法回顾性纳入89例重度心力衰竭合并持续性AF患者,依据患者CHADS2评分及HAS-BLED评分情况给予不同的抗栓药物,分为两组:研究组(n=43),应用华法林治疗;对照组(n=46),应用阿司匹林治疗。比较两组患者缺血性事件(包括缺血性脑卒中、短暂性脑缺血发作、外周动脉栓塞)和出血事件(包括颅内出血、胃肠道出血、泌尿系出血)发生率的差异。结果与对照组比较,研究组患者缺血性脑卒中、短暂性脑缺血发作、外周动脉栓塞发生率显著降低,分别为:4.65%vs.15.22%、11.63%vs.21.74%、2.33%vs.8.69%,差异有统计学意义(P均<0.05);研究组与对照组出血性事件包括颅内出血、胃肠道出血、泌尿系出血发生率分别为:2.33%vs.2.17%、9.30%vs.10.86%、9.30%vs.8.69%,差异均无统计学意义(P>0.05)。随访1年,研究组与对照组患者猝死率分别为:6.98% vs.6.52%,差异无统计学意义(P>0.05)。结论依据CHADS2评分及HAS-BLED评分情况进行选择,华法林能降低重度心力衰竭合并持续性AF患者缺血性事件的发生率,而不增加出血性事件发生率。
目的:探討華法林和阿司匹林在重度心力衰竭閤併持續性心房顫動(AF)抗栓治療中的臨床療效。方法迴顧性納入89例重度心力衰竭閤併持續性AF患者,依據患者CHADS2評分及HAS-BLED評分情況給予不同的抗栓藥物,分為兩組:研究組(n=43),應用華法林治療;對照組(n=46),應用阿司匹林治療。比較兩組患者缺血性事件(包括缺血性腦卒中、短暫性腦缺血髮作、外週動脈栓塞)和齣血事件(包括顱內齣血、胃腸道齣血、泌尿繫齣血)髮生率的差異。結果與對照組比較,研究組患者缺血性腦卒中、短暫性腦缺血髮作、外週動脈栓塞髮生率顯著降低,分彆為:4.65%vs.15.22%、11.63%vs.21.74%、2.33%vs.8.69%,差異有統計學意義(P均<0.05);研究組與對照組齣血性事件包括顱內齣血、胃腸道齣血、泌尿繫齣血髮生率分彆為:2.33%vs.2.17%、9.30%vs.10.86%、9.30%vs.8.69%,差異均無統計學意義(P>0.05)。隨訪1年,研究組與對照組患者猝死率分彆為:6.98% vs.6.52%,差異無統計學意義(P>0.05)。結論依據CHADS2評分及HAS-BLED評分情況進行選擇,華法林能降低重度心力衰竭閤併持續性AF患者缺血性事件的髮生率,而不增加齣血性事件髮生率。
목적:탐토화법림화아사필림재중도심력쇠갈합병지속성심방전동(AF)항전치료중적림상료효。방법회고성납입89례중도심력쇠갈합병지속성AF환자,의거환자CHADS2평분급HAS-BLED평분정황급여불동적항전약물,분위량조:연구조(n=43),응용화법림치료;대조조(n=46),응용아사필림치료。비교량조환자결혈성사건(포괄결혈성뇌졸중、단잠성뇌결혈발작、외주동맥전새)화출혈사건(포괄로내출혈、위장도출혈、비뇨계출혈)발생솔적차이。결과여대조조비교,연구조환자결혈성뇌졸중、단잠성뇌결혈발작、외주동맥전새발생솔현저강저,분별위:4.65%vs.15.22%、11.63%vs.21.74%、2.33%vs.8.69%,차이유통계학의의(P균<0.05);연구조여대조조출혈성사건포괄로내출혈、위장도출혈、비뇨계출혈발생솔분별위:2.33%vs.2.17%、9.30%vs.10.86%、9.30%vs.8.69%,차이균무통계학의의(P>0.05)。수방1년,연구조여대조조환자졸사솔분별위:6.98% vs.6.52%,차이무통계학의의(P>0.05)。결론의거CHADS2평분급HAS-BLED평분정황진행선택,화법림능강저중도심력쇠갈합병지속성AF환자결혈성사건적발생솔,이불증가출혈성사건발생솔。
Objective To investigate the curative effects of warfarin and aspirin during anticoagulant treatment in patients with severe heart failure complicating persistent atrial fibrillation (AF). Methods The patients (n=89) were retrospectively chosen and divided, according to CHADS2 scoring, HAS-BLED scoring and different anticoagulant drug administrating, into research group (n=43) treated with warfarin and control group (n=46) treated with aspirin. The incidence rates of ischemia events (including ischemic stroke, transient cerebral ischemic attack and peripheral arterial embolism) and hemorrhagic events (including intracranial hemorrhage, gastrointestinal bleeding and urinary bleeding) were compared between 2 groups. Results The incidence rates of ischemic stroke, transient cerebral ischemic attack and peripheral arterial embolism decreased significantly in research group compared with control group (4.65% vs. 15.22%, 11.63% vs. 21.74% and 2.33% vs. 8.69%, all P<0.05). The incidence rates of intracranial hemorrhage, gastrointestinal bleeding and urinary bleeding were, respectively, 2.33%vs. 2.17%, 9.30%vs. 10.86%and 9.30%vs. 8.69%in research group and control group (P>0.05). After following up for 1 y, the sudden death rate was, respectively, 6.98%vs. 6.52%in research group and control group (P>0.05). Conclusion According to CHADS2 scoring and HAS-BLED scoring, warfarin can reduce the incidence of ischemia events and not increase that of hemorrhagic events in patients with severe heart failure complicating permanent AF.