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|本期目录/Table of Contents|

二尖瓣狭窄并发房颤行球囊成形术前抗凝与不抗凝的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第6期
页码:
471-472
栏目:
论著
出版日期:
2000-12-01

文章信息/Info

Title:
Comparison between anticoagulation and non-anticoagulation in patients with atrial fibrillation secondary to mitral stenosis before percutaneous balloon mitral valvuloplasty
作者:
傅　强;  张义勤;  骆秉铨;  王临光;  吴　强
徐州市心血管病研究所, 徐州市第四医院心内科, 江苏徐州221009
Author(s):
FU Qiang;  ZHANG Yi-qin;  LUO Bing-quan;  WANG Lin-Guang;  WU Qiang
Department of cardiology, Cardiovascular disease institute and the fourth people's hospital in Xuzhou, Xuzhou Jiangsu 221009, China
关键词:
风湿性心脏病;  二尖瓣狭窄;  心房颤动;  气囊扩张术;  抗凝治疗
Keywords:
rheumatic heart disease;  mitral stenosis;  atrial fibrillation;  balloon dilatation;  anticoagulation treatme
分类号:
R654.2; R973.2
DOI:
-
文献标识码:
A
摘要:
目的 评价二尖瓣狭窄并发房颤患者行经皮二尖瓣球囊成形术 (PBMV)前是否需要常规抗凝治疗。方法 风湿性心脏病二尖瓣狭窄并发房颤患者 2 5 1例 ,按就诊先后随机分为 A(n=126 ) ,B(n=12 5 )两组。控制心力衰竭后行PBMV。A组术前不使用任何抗凝药物及抗血小板药物 ,B组术前常规给予肝素、肠溶阿斯匹林及华法令抗凝 ,观察PBMV术中及术后 3d有无与 PBMV相关的体循环栓塞并发症。结果 两组患者 PBMV均获成功 ,术中及术后均无栓塞并发症发生 ,术后血流动力学指标、心功能、二尖瓣口面积、心脏杂音均有明显改善 (P<0 .0 1)。结论 二尖瓣狭窄并发房颤患者如既往无体循环栓塞史 ,左心房无附壁血栓 ,行 PBMV前并不需苛求常规抗凝。
Abstract:
AIM To evaluate whether or not the regular anticoagulation therapy are needed before percutaneous balloon mitral valvuloplasty (PBMV) in patients with atrial fibrillation (AF) secondary to mitral stenosis. METHODS 251 patients with AF secondary to mitral stenosis were divided into group A( n =126) and group B ( n =125). No drugs of anticoagulation and antiplatelet were used in group A and heparin,aspirin and warfarin were used in group B before PBMV. Observed whether the systemic thromboembolism occured or not during and after PBMV. RESULTS No systemic embolism occured during and after PBMV in both group A and group B. The parameters of hemodynamics, mitral valve area and cardiac function improved markedly (P < 0101). CONCLUSION Anticoagulation treatment wasn't needed in patients with AF secondary to mitral stenosis before PBMV if they hadn’t the history of systemic thromboembolism and left atrial thrombus.

参考文献/References

[1] 傅　强, 张义勤, 骆秉铨, 等. 自制球囊导管经皮二尖瓣成形术95例临床应用[J]. 江苏医药, 1997, 23 (10) : 712.

[2] Li-Saw-Hee FL, Blann AD, Goldsmith L, et al. Indexs of hypercoagulability measured in peripheral blood reflect levels in intracardiac blood in patients with atrial fibrillation secondary to mitral stenosis[J]. Am J Cardiol, 1999, 83 (8) : 1206.

[3] Peverill RE, Harper RW , Gelman J, et al. Effect of warfarin on regional left atrial coagulation activity in mitral stenosis[J]. Am J Cardiol, 1997, 79 (3) : 339.

[4] Yamamoto K, Ikeda U , Seino Y, et al. Coagulation activity is increaed in the left atrium of patients with mitral setenosis[J].JACC, 1995, 25 (1) : 107.

[5] Peverill RE, Harper RW, Gelman J. Determinants of increased regional left artrial coagulant activity in patients with mitral stenosis[J]. Circulation, 1996, 94 (3) : 331.

备注/Memo

备注/Memo:
收稿日期：2000-05-11.
更新日期/Last Update: 2000-12-01