抗凝可防房颤患者痴呆发生

2019-12-07 佚名 中国循环杂志

很多都发现房颤会增加痴呆风险,比如兰州大学第二医院学者研究就,高达40%的房颤患者存在血管性痴呆。不过抗凝治疗到底是能预防痴呆还是因可能增加脑微出血风险而增加痴呆?阿司匹林管用吗?

很多都发现房颤会增加痴呆风险,比如兰州大学第二医院学者研究就,高达40%的房颤患者存在血管性痴呆。不过抗凝治疗到底是能预防痴呆还是因可能增加脑微出血风险而增加痴呆?阿司匹林管用吗?

南京大学医学院附属鼓楼医院葛卫红、回翔等对14项中外研究进行的Meta分析显示:给予合理抗凝治疗,维持较高治疗窗内时间(TTR)有助于预防、延缓房颤患者认知功能障碍或痴呆的发生。

研究显示,与不接受抗凝治疗或仅服用阿司匹林相比,接受口服抗凝药物治疗可降低26%的认知功能障碍及痴呆发生风险。

就华法林而言,共分析了5项336977例患者。研究显示,与不服用华法林相比,服用者可显着降低患者认知功能减退和痴呆风险。

此外,还有两项研究7065例患者中进行的分析显示,TTR≤25%较TTR>75%者增加2.02倍认知功能减退和痴呆发生风险。

研究者强调,定期复查监测国际标准化比值(INR),合理调整剂量以维持较高的TTR,不仅有效预防脑卒中血栓或出血事件的发生,还是房颤合并痴呆的有效保护因素。

还有两项研究共449360例房颤结果表明,华法林和新型口服抗凝药物疗效相似。

这项研究共纳入14项研究797 851 例心房颤动患者。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1614527, encodeId=123d161452e24, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Mon Dec 09 13:19:00 CST 2019, time=2019-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376713, encodeId=ec2b3e6713c7, content=学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201031/68bd1e468a5b4b94a6d4d57ed4253bc5/e6bf210dcac542b890ccc1ae1e433a21.jpg, createdBy=2eb51948381, createdName=1e109f88m97(暂无匿称), createdTime=Sun Dec 08 23:48:47 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031199, encodeId=d5f1103119970, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Sun Dec 08 01:19:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048581, encodeId=90b8104858125, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Dec 08 01:19:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1614527, encodeId=123d161452e24, content=<a href='/topic/show?id=64f95426122' target=_blank style='color:#2F92EE;'>#房颤患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54261, encryptionId=64f95426122, topicName=房颤患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=937e19519012, createdName=hittouch, createdTime=Mon Dec 09 13:19:00 CST 2019, time=2019-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=376713, encodeId=ec2b3e6713c7, content=学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201031/68bd1e468a5b4b94a6d4d57ed4253bc5/e6bf210dcac542b890ccc1ae1e433a21.jpg, createdBy=2eb51948381, createdName=1e109f88m97(暂无匿称), createdTime=Sun Dec 08 23:48:47 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031199, encodeId=d5f1103119970, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Sun Dec 08 01:19:00 CST 2019, time=2019-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048581, encodeId=90b8104858125, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Dec 08 01:19:00 CST 2019, time=2019-12-08, status=1, ipAttribution=)]
    2019-12-08 1e109f88m97(暂无匿称)

    学习啦

    0

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    2019-12-08 心介

    房颤,临床上碰到很多哦

    0

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    2019-12-08 junJUN

    老年人痴呆何药可用??

    0

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