抗凝治疗对合并心房颤动的老年血液透析患者脑卒中发生的影响被引量：18

Effect of anticoagulant therapy on ischemic stroke in elderly AF patients on hemodialysis

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摘要目的观察抗凝治疗对合并心房颤动（房颤）的老年血液透析（HD）患者脑卒中发生的影响。方法选择我院血液透析中心60~78岁患者160例,随机分为房颤组80例和非房颤组80例,对CHADS2评分≥2分的患者又分为华法林亚组40例和非华法林亚组40例,观察并发房颤的老年HD患者脑卒中的发生率及华法林的疗效。结果与非房颤组比较,房颤组缺血性脑卒中（31.25%vs 18.75%）和脑出血发生率（8.75%vs 1.25%）显著升高（P〈0.05）。华法林亚组发生缺血性脑卒中显著低于非华法林亚组,发生脑出血显著高于非华法林亚组,2组比较差异有统计学意义（P〈0.05）。结论房颤是老年HD患者发生缺血性脑卒中的常见原因,而华法林可降低由此而引发的脑卒中,但出血概率会增加。对并发房颤的老年HD患者应衡量利弊进行抗凝治疗,以降低脑卒中的发生。 Objective To observe the effect of anticoagulant therapy on ischemic stroke in elderly AF patients on hemodialysis.Methods One hundred and sixty patients aged 60-78 years on hemodialysis were randomly divided into AF group（n=80）and non-AF group（n=80）.The AF patients with their CHADS2score≥2were treated with oral warfarin,during which the incidence of ischemic stroke and the curative effect of warfarin were recorded.Results The incidence of ischemic stroke（31.25%vs 18.75%）and cerebral hemorrhage（8.75% vs 1.25%）was significantly higher in AF group than in non-AF group（P〈0.05）.The incidence of ischemic stroke was significantly lower whereas that of cerebral hemorrhage was significantly higher in warfarin treatment group than in non-warfarin treatment group（P〈0.05）.Conclusion AF is a common risk factor for ischemic stroke in elderly AF patients.Warfarin can reduce the incidence of ischemic stroke and increase that of cerebral hemorrhage.Elderly AF patients should be treated with anticoagulant therapy in order to reduce the incidence of ischemic stroke.

作者田永霞马长红赵明明陈国俊

机构地区黑龙江三精肾脏病专科医院心内科秦皇岛市海港医院综合内科黑龙江三精肾脏病专科医院血液透析中心黑龙江省医院心内科

出处《中华老年心脑血管病杂志》 CAS 2016年第4期388-390,共3页 Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

关键词抗凝药心房颤动肾透析卒中华法林 anticoagulants atrial fibrillation renal dialysis stroke warfarin

分类号 R541.75 [医药卫生—心血管疾病] R743.3 [医药卫生—神经病学与精神病学]

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