Warfarin reduces silent cerebral infarction in elderly patients with atrial fibrillation
Warfarin reduces silent cerebral infarction in elderly patients with atrial fibrillation
复制标题
华法林可减少老年房颤患者的无症状性脑梗塞
DOI：
10.1097/00019501-199809040-00008
复制
发表时间：
1998
影响因子：
1.8
通讯作者：
M. Kinoshita
中科院分区：
文献类型：
--
作者：
S. Matsuo;Y. Nakamura;M. Kinoshita
背景 据报道，心房颤动是无症状性脑梗塞的危险因素之一。志贺心房颤动试验在五个医疗中心进行，旨在检验华法林可以预防房颤患者无症状脑梗塞的假设。方法对 15 名无症状心房颤动患者（74 ± 4 岁）在患者进入研究时和一年后拍摄磁共振图像 (MRI)，这些患者被随机分配到接受或不接受华法林的两个治疗组。使用四点量表对脑室周围和半卵圆中心区域的 T2 加权轴 MRI 上的高信号频率进行评级。总无症状脑梗死评分按 MRI 评分之和计算。结果15例房颤患者中14例（93%）出现无症状脑梗死，共检出109个无症状脑梗死病灶。在研究的 1 年中，脑室周围和半卵圆中心区域的高信号数量有所增加 (P < 0.01)。华法林治疗组一年内总分的增幅较小（1.6±0.7 与 5.4±0.9 相比，P < 0.05）。结论对于神经功能正常的老年房颤患者，抗凝治疗可有效预防无症状性脑梗死。
BackgroundAtrial fibrillation is reportedly one of the risk factors of silent cerebral infarction. The Shiga Atrial Fibrillation Trial was conducted in five medical centers, to test the hypothesis that warfarin can prevent silent cerebral infarction in patients with atrial fibrillation. MethodsMagnetic resonance images (MRI) were taken at the time of the patient's entry to the study and 1 year later in 15 asymptomatic patients (74 ± 4 years old) with atrial fibrillation who were randomly allocated to two treatment groups to receive or not receive warfarin. The frequency of hyperintensities on T2-weighted axis MRI was rated using a four-point scale in the periventricular and centrum semiovale areas. Total silent cerebral infarction scores were calculated at the sum of the scores on MRI. ResultsSilent cerebral infarction was seen in 14 (93%) of the 15 patients with atrial fibrillation and a total of 109 silent cerebral infarction lesions were detected. The number of hyperintensities in the periventricular and centrum semiovale areas increased over the 1 year of study (P < 0.01). The increase in total score over 1 year was less in the warfarin-treated group (1.6 ± 0.7 compared with 5.4 ± 0.9, P < 0.05). ConclusionAnticoagulation therapy can be useful to prevent silent cerebral infarction in neurologically normal elderly patients with atrial fibrillation.