心血管内科非瓣膜性心房颤动住院患者抗凝治疗现状分析

摘要

Objective To investigate the present situations of anticoagulant treatment of non-valvular atri-al fibrillation in order to get better guidance of the clinical anticoagulant therapy and reduce the incidence of stroke caused by atrial fibrillation. Methods The clinical data of NVAF patients hospitalized in the first affili-ated hospital of Chongqing Medical University from January 1 , 2012 to December 31 , 2014 were retrospectively reviewed and analyzed in terms of basic characteristics , medical treatment plan and INR monitoring. Results A total of 1,390 patients were enrolled, 85.97% of whom needed anticoagulant therapy and 25.18% of whom were treated with anticoagulants. For 15.71% of the NVAF patients treated with warfarin , INR met the standard during hospitalization. In the study, such factors as age, coronary heart disease, history of stroke and history of bleed-ing might affect prescription of anticoagulant drugs. Conclusion Most NVAF patients need anticoagulant thera-py, but the rate of anticoagulant therapy is lower than we expected. Among those patients treated with warfarin during hospitalization , the rate of INR meeting the standard is at a lower level. The novel oral anticoagulants are not in wide use in the clinical practice.%目的：调查目前心血管内科非瓣膜性心房颤动住院患者抗凝治疗现状，以期更好指导临床抗凝治疗，减少房颤导致的卒中事件。方法：采用回顾性病例分析，收集2012年1月1日至2014年12月31日3年内入院重庆医科大学附属第一医院心血管内科的非瓣膜性房颤患者，记录基本特征、药物治疗方案及国际标准化比率（INR）监测情况。结果：共纳入非瓣膜性房颤患者1390例，有抗凝指征者85．97％，抗凝治疗率25．18％。华法林抗凝治疗的患者，住院期间INR达标率15．71％。年龄、合并冠心病、既往脑卒中病史、出血史等可能影响医生处方抗凝药物。结论：房颤患者多需抗凝治疗，但目前抗凝治疗率低，华法林抗凝治疗者住院期间INR达标率低，新型口服抗凝药物尚未广泛应用。