华法林对老年2型糖尿病合并心房颤动患者的效果观察

    Effect of warfarin on elderly patients with type 2 diabetes complicated with atrial fibrillation

    • 摘要: 目的:观察华法林对老年2型糖尿病合并心房颤动(房颤)患者抗凝治疗的效果。方法:选择132例75岁以上2型糖尿病合并房颤患者,随机分为华法林中等强度组国际标准化比值(INR)维持在2.1~2.5,华法林低等强度组(INR维持在1.5~2.0),对照组(口服阿司匹林),每组44例。随访1年,记录血栓栓塞和出血事件发生率。结果:华法林中等强度组、低等强度组和对照组血栓栓塞事件呈逐渐增多,对照组血栓栓塞发生率高于华法林中等和低等强度组(P<0.05),中等和低等强度组血栓栓塞发生率差异无统计学意义(P>0.05)。中等强度组、低等强度组和对照组出血事件呈逐渐减少,中等强度组出血发生率均高于低等强度组和对照组(P<0.05),但对照组出血发生率与低等强度组差异无统计学意义(P>0.05)。结论:华法林治疗老年2型糖尿病合并房颤患者,INR维持在1.5~2.0,不仅能够取得最佳的抗凝效果,同时能够有效地避免出血事件的发生。

       

      Abstract: Objective: To observe the anticoagulant effect of warfarin in the treatment of elderly patients with type 2 diabetes complicated with atrial fibrillation.Methods: One hundred and thirty-two diabetic patients complicated with atrial fibrillation with the age over 75 were divided into warfarin moderate intensity groupinternational normalized ratio(INR) was maintained at 2.1-2.5,warfarin low intensity group INR was maintained at 1.5-2.0 and control group(aspirin),each group consisting of 44 cases.All the cases were followed up for 1 year.The incidence of thromboembolism and bleeding events were recorded.Results: The incidence of thromboembolic events tended to increase in the moderate intensity group,low intensity group and control group;the incidence of thromboembolism in the control group was higher than that in the warfarin moderate intensity group and low intensity group(P<0.05);the difference in the thrombembolia rate had no statistical significance between the moderate intensity group and the low intensity group(P>0.05).The bleeding events tended to reduce in the moderate intensity group,low intensity group and control group;the bleeding rate of the moderate intensity group was higher than that of the low intensity group and the control group(P<0.05);but the bleeding rate in the control group had no statistical significance compared with that in the low intensity group(P>0.05).Conclusions: warfarin is effective on senile diabetic patients complicated with atrial fibrillation when the INR value is maintained at 1.5-2.0,which may achieve the best anticoagulant effect and avoid the occurrence of bleeding events.

       

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