目的:评价华法林对风湿性房颤与非风湿性房颤患者预防脑血栓和周围血栓的有效性,安全性及不良反应发生率.方法:选择本研究抗凝标准的风湿性房颤与非风湿性房颤176例,其中风湿性房颠86例,非风湿性房颤90例.按照国际标准化比率给华法林口服治疗.观察两组血栓栓塞的年发生率、出血等不良反应.结果:两组血栓栓塞年发生率、风湿性房颤为0.58％,非风湿性房颤为0.53％,两组比较差异无显著性,两组病例中97％的不良反应为出血,风湿性房颤出血不良反应年发生率为9.7％,非风湿性房颤年发生率为2.6％,两组比较差异显著(P＜0.05).结论:风湿性房颤合并右心衰者,华法林起始用量偏小,抗凝的强度INR1.8-2.8之间,能明显降低血栓栓塞的发生率,其安全性好.非风湿性房颤华法林用量偏大,抗凝的强度INR1.8-2.5之间,能显著降低血栓栓塞发生率,安全性好.%Objective: To evaluate the effectiveness and safety of warfarin on patients with rheumatic at-rial flutter (AF) and non-rheumatic atrial flutter to prevent the cerebral thrombus as well as the not good responses. Method: All 176 patients ,86 with rheumatic atrial flutter and 90 with non-rheumatic atrial flutter. They were given warfarin according to the international standardized ratio (INR). We observed the percentage of occurrence. Result:The percentage of occurrence of thrombi embolism in patients with rheumatic atrial flutter was 0.58% ,and that in patients with non rheumatic atrial flutter was 0.53%. There's no difference between the two groups. On the other hand, We observed that 97% of not good responses were hemorrhage and the percentage of occurrence of hemorrhage in patients with rheumatic atrial flutter was 9.7% ,and that in patients with non rheumatic atrial flutter was 2.6%. Conclusion:The dose amount of wafarin for the patients with rheumatic atrial flutter as well as right heart failure is small, and the anticlotting intensity INR is between 1.8-2. 8 ,which can reduce the occurrence of clotting remarkably atrial flutter is large,and the anti-clotting intensity INR is between 1.8-2.5 .which can reduce the occurrence of clotting remarkable with good safety.
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