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206例老年心房颤动患者抗栓治疗及血管事件发生情况5年随访
引用本文:张善春,吴卫平,王振福,张熙,孙虹,王婷,陈海波,管锦群.206例老年心房颤动患者抗栓治疗及血管事件发生情况5年随访[J].中华老年心脑血管病杂志,2012,14(5).
作者姓名:张善春  吴卫平  王振福  张熙  孙虹  王婷  陈海波  管锦群
作者单位:解放军总医院南楼神经内科,北京,100853
摘    要:目的分析老年心房颤动(房颤)患者近5年抗栓治疗现状及血管事件发生情况。方法回顾性分析2005年1月~2006年6月入住我院的年龄≥75岁房颤患者206例,记录主要合并疾病、抗栓治疗方法及5年内栓塞、严重出血及死亡事件发生情况。结果 206例房颤患者中共发生栓塞事件47次,年发生率为4.56%。严重出血事件3次,年发生率为0.29%。行阿司匹林抗血小板治疗70例,氯吡格雷治疗66例,氯吡格雷联合阿司匹林抗血小板治疗11例,未行抗栓治疗56例。行华法林抗凝治疗3例,随访期间更换为抗凝治疗11例。抗凝时间平均2年1个月。结论老年房颤患者栓塞事件年发生率高,预防栓塞具有重要的临床意义。华法林抗凝治疗率低,抗凝治疗时间短。

关 键 词:心房颤动  血栓栓塞  血小板聚集抑制剂  阿司匹林  抗凝药  华法林

Five-year follow-up of antithrombotic therapy for atrial fibrillation and vascular events in 206 elderly patients
Abstract:Objective To analyze the status quo and vascular events of antithrombotic therapy for elderly atrial fibrillationC AF) patients in recent 5 years.Methods Clinical data about 206 AF patients aged≥75 years admitted to our hospital from January 2005 to June 2006 were retrospectively analyzed.Their major combined diseases,antithrombotic therapies,events of thrombosis,severe hemorrhage and death were recorded.Results Thrombosis occurred 47 times and severe hemorrhage occurred 3 times in the 206 patients with an annual incidence of 4.56%and 0.29%, respectively.Of the 206 patients,70 were treated with asprin,66 with clopidogrel,11 with combined asprin and clopidogrel,56 did not receive antithrombotic therapy,and 3 were treated with warfarin.The patients were followed up,during which 11 changed to receive warfarint.The average time of antithrombotic therapy was 25 months.Conclusion The incidence of thrombosis is high in elderly AF patients,antithrombotic therapy is thus of vital importance.The curative effect of warfarin on thrombosis is lower and the treatment time of warfarin is shorter than those of aspirin.
Keywords:atrial fibrillation thromboembolism  platelet aggregation inhibitors  aspirin  anticoagulants  warfarin
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