临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
2期
111-114
,共4页
戴萌%李滨%王忠明%董秋立%杨雪佳
戴萌%李濱%王忠明%董鞦立%楊雪佳
대맹%리빈%왕충명%동추립%양설가
非瓣膜性房颤%抗栓治疗%血栓栓塞%出血事件
非瓣膜性房顫%抗栓治療%血栓栓塞%齣血事件
비판막성방전%항전치료%혈전전새%출혈사건
Non - valvular atrial fibrillation%Antithrombotic therapy%Thromboembolism%Bleeding event
目的：探讨抗栓治疗在低危、中危非瓣膜性房颤（NVAF）中的疗效。方法选取2010年2月至2014年6月期间收治的128例 NVAF 患者为研究对象。根据 CHA2DS2- VASc 评分将其分为低危组（62例，CHA2DS2- VASc 评分为0分）和中危组（66例，CHA2DS2- VASc 评分为1分）。将低危组62例患者随机分为安慰剂组（A 组，30例）和阿司匹林组（B 组，32例）。将中危组66例患者随机分为阿司匹林联合氯吡格雷组（ C 组，32例）和华法林组（ D 组，34例）。评价四组患者血栓栓塞事件、出血事件发生情况。结果 A 组和 B 组、C 组和 D 组患者发病原因构成无明显差异（ P ﹥0.05）。A 组、B 组、C 组、D 组患者心功能均以 NYHA I 级为主，四组在心功能方面无明显差异（ P ﹥0.05）。A组、B 组、C 组、D 组患者不良反应及出血时国际标准化比值（INR）均无明显差异（ P ﹥0.05）。A 组和 B 组患者脑卒中、短暂性脑缺血发作、血栓栓塞发生率无明显差异（ P ﹥0.05）。C 组和 D 组患者脑卒中发生率无明显差异（ P ﹥0.05），但 C 组短暂性脑缺血发作发生率高于 D 组（χ2＝4.3453，P ＝0.0371），C 组血栓栓塞发生率高于 D 组（χ2＝5.5479，P＝0.0185）。结论阿司匹林对预防低危 NVAF 患者血栓栓塞事件无明显影响。华法林可减少中危 NVAF 患者血栓栓塞事件发生风险，且并未明显增加患者出血风险。
目的：探討抗栓治療在低危、中危非瓣膜性房顫（NVAF）中的療效。方法選取2010年2月至2014年6月期間收治的128例 NVAF 患者為研究對象。根據 CHA2DS2- VASc 評分將其分為低危組（62例，CHA2DS2- VASc 評分為0分）和中危組（66例，CHA2DS2- VASc 評分為1分）。將低危組62例患者隨機分為安慰劑組（A 組，30例）和阿司匹林組（B 組，32例）。將中危組66例患者隨機分為阿司匹林聯閤氯吡格雷組（ C 組，32例）和華法林組（ D 組，34例）。評價四組患者血栓栓塞事件、齣血事件髮生情況。結果 A 組和 B 組、C 組和 D 組患者髮病原因構成無明顯差異（ P ﹥0.05）。A 組、B 組、C 組、D 組患者心功能均以 NYHA I 級為主，四組在心功能方麵無明顯差異（ P ﹥0.05）。A組、B 組、C 組、D 組患者不良反應及齣血時國際標準化比值（INR）均無明顯差異（ P ﹥0.05）。A 組和 B 組患者腦卒中、短暫性腦缺血髮作、血栓栓塞髮生率無明顯差異（ P ﹥0.05）。C 組和 D 組患者腦卒中髮生率無明顯差異（ P ﹥0.05），但 C 組短暫性腦缺血髮作髮生率高于 D 組（χ2＝4.3453，P ＝0.0371），C 組血栓栓塞髮生率高于 D 組（χ2＝5.5479，P＝0.0185）。結論阿司匹林對預防低危 NVAF 患者血栓栓塞事件無明顯影響。華法林可減少中危 NVAF 患者血栓栓塞事件髮生風險，且併未明顯增加患者齣血風險。
목적：탐토항전치료재저위、중위비판막성방전（NVAF）중적료효。방법선취2010년2월지2014년6월기간수치적128례 NVAF 환자위연구대상。근거 CHA2DS2- VASc 평분장기분위저위조（62례，CHA2DS2- VASc 평분위0분）화중위조（66례，CHA2DS2- VASc 평분위1분）。장저위조62례환자수궤분위안위제조（A 조，30례）화아사필림조（B 조，32례）。장중위조66례환자수궤분위아사필림연합록필격뢰조（ C 조，32례）화화법림조（ D 조，34례）。평개사조환자혈전전새사건、출혈사건발생정황。결과 A 조화 B 조、C 조화 D 조환자발병원인구성무명현차이（ P ﹥0.05）。A 조、B 조、C 조、D 조환자심공능균이 NYHA I 급위주，사조재심공능방면무명현차이（ P ﹥0.05）。A조、B 조、C 조、D 조환자불량반응급출혈시국제표준화비치（INR）균무명현차이（ P ﹥0.05）。A 조화 B 조환자뇌졸중、단잠성뇌결혈발작、혈전전새발생솔무명현차이（ P ﹥0.05）。C 조화 D 조환자뇌졸중발생솔무명현차이（ P ﹥0.05），단 C 조단잠성뇌결혈발작발생솔고우 D 조（χ2＝4.3453，P ＝0.0371），C 조혈전전새발생솔고우 D 조（χ2＝5.5479，P＝0.0185）。결론아사필림대예방저위 NVAF 환자혈전전새사건무명현영향。화법림가감소중위 NVAF 환자혈전전새사건발생풍험，차병미명현증가환자출혈풍험。
Objective To investigate the effect of antithrombotic therapy in the low - risk and intermediate - risk non - valvular atrial fi-brillation(NVAF). Methods One hundred twenty - eight NVAF patients treated in our hospital during Feb. 2010. ~ Jun. 2014 were selected for the study. According to CHA2DS2 - VASc score,128 patients were divided into low - risk group(62 cases,CHA2DS2 - VASc score was 0) and intermediate - risk group(66 cases,CHA2DS2 - VASc score was 1). Patients in low - risk group were further randomly divided into place-bo group(group A,30 cases)and aspirin group(group B,32 cases). Patients in intermediate - risk group were further randomly divided into combined clopidogrel and aspirin group(group C,32 cases)and warfarin group(group D,34 cases). The occurrence of hemorrhagic and throm-boembolic events in the 4 groups were evaluated. Results There was no difference in the causes of the disease between group A and group B( P﹥ 0. 05)and between group C and group D( P ﹥ 0. 05). There was no difference in the cardiac function(patients were mainly NYHA I),inci-dence of adverse reaction,and international normalized ratio(INR)among 4 groups(all P ﹥ 0. 05). No differences were found in the incidences of stroke,transient ischemic attack,and thrombus embolism between group A and group B( P ﹥ 0. 05). Although no difference in the incidence of stroke between group C and group D( P ﹥ 0. 05),the incidences of transient ischemic attack and thromboembolism of group C were higher than group D(χ2 = 4. 3453,P = 0. 0371;and χ2 = 5. 5479,P = 0. 0185,respectively). Conclusion Aspirin has no obvious effect on prevention of thromboembolic events in patients with low - risk NVAF. Warfarin can reduce the risk of thromboembolism in intermediate - risk NVAF patients, but not significantly increase the risk of bleeding.
