华法林对心房颤动患者脑卒中严重程度及住院费用的影响

发布时间：2018-01-27 13:18

  本文关键词： 华法林 心房颤动 脑卒中 NIHSS评分 住院费用　出处：《首都医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究旨在评价服用华法林与未服用华法林的非瓣膜性心房颤动患者若发生脑卒中,其卒中严重程度及住院费用的差别,为预防心房颤动脑卒中、减轻疾病负担提供参考依据。方法:在位于北京市的7家三级医院和2家非三级医院中,回顾性连续入选2012年1月至2014年3月在神经科住院治疗且主要诊断为脑卒中或短暂性脑缺血发作(Transient Ischemic Attack,TIA)的心房颤动患者,依据其卒中前是否服用华法林分为两组,收集并比较两组患者的人口学特征、合并疾病、检查结果、住院当天的美国国立卫生院神经功能缺损评分(National Institute of Health stroke scale,NIHSS)、住院天数、住院总费用等;通过logistic单因素及多因素回归校正年龄、性别等资料后,分析服用华法林与脑卒中严重程度及住院费用的关系。结果:共纳入260例患者,其中服用华法林组51例(19.6%),未服用华法林组209例(80.4%)。服用华法林组NIHSS评分小于未服用华法林组(4.1±4.4 VS 7.9±8.5),住院总费用少于未服用华法林组(16659.7 VS 19597.80,差异均有统计学意义(P0.05)。多因素分析显示服用华法林且INR≥2可降低NIHSS评分(odds ratio=0.24,95%CI:0.07-0.85,P=0.027),服用华法林可减少房颤脑卒中患者的住院费用,(β=-0.10,95%CI:-0.18~-0.02,P=0.018),差异有统计学意义。结论:服用华法林且INR≥2的心房颤动患者若发生脑卒中其严重程度及住院费用均小于未服用华法林的患者。
[Abstract]:Objective: to evaluate the severity of stroke and the cost of hospitalization in patients with non-valvular atrial fibrillation (NAF) taking warfarin and without warfarin, so as to prevent stroke from atrial fibrillation. Methods: in 7 tertiary hospitals and 2 non-tertiary hospitals in Beijing. A retrospective study was conducted between January 2012 and March 2014 in the neurology department where the patients were mainly diagnosed as stroke or transient ischemic attack (TIA). Transient Ischemic Attack. TIA patients with atrial fibrillation were divided into two groups according to whether they took warfarin before stroke. The demographic characteristics of the two groups were collected and compared. The National Institute of Health stroke scale (NIHSS) was used to evaluate the neurological impairment of the National Institutes of Health (NIH) on the day of hospitalization. Days of hospitalization, total cost of hospitalization, etc. The relationship between taking warfarin and stroke severity and hospitalization cost was analyzed by univariate and multivariate regression of logistic. Results: 260 patients were included. In the warfarin group, 51 cases were treated with warfarin. The NIHSS score in warfarin group was lower than that in warfarin group (4.1 卤4.4 vs 7.9 卤8.5). The total cost of hospitalization was less than that of warfarin group (16659.7 vs 19597.80). Multivariate analysis showed that taking warfarin and INR 鈮，

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