本文關(guān)鍵詞： 華法林 心房顫動(dòng) 腦卒中 NIHSS評分 住院費(fèi)用　出處：《首都醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究旨在評價(jià)服用華法林與未服用華法林的非瓣膜性心房顫動(dòng)患者若發(fā)生腦卒中,其卒中嚴(yán)重程度及住院費(fèi)用的差別,為預(yù)防心房顫動(dòng)腦卒中、減輕疾病負(fù)擔(dān)提供參考依據(jù)。方法:在位于北京市的7家三級醫(yī)院和2家非三級醫(yī)院中,回顧性連續(xù)入選2012年1月至2014年3月在神經(jīng)科住院治療且主要診斷為腦卒中或短暫性腦缺血發(fā)作(Transient Ischemic Attack,TIA)的心房顫動(dòng)患者,依據(jù)其卒中前是否服用華法林分為兩組,收集并比較兩組患者的人口學(xué)特征、合并疾病、檢查結(jié)果、住院當(dāng)天的美國國立衛(wèi)生院神經(jīng)功能缺損評分(National Institute of Health stroke scale,NIHSS)、住院天數(shù)、住院總費(fèi)用等;通過logistic單因素及多因素回歸校正年齡、性別等資料后,分析服用華法林與腦卒中嚴(yán)重程度及住院費(fèi)用的關(guān)系。結(jié)果:共納入260例患者,其中服用華法林組51例(19.6%),未服用華法林組209例(80.4%)。服用華法林組NIHSS評分小于未服用華法林組(4.1±4.4 VS 7.9±8.5),住院總費(fèi)用少于未服用華法林組(16659.7 VS 19597.80,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素分析顯示服用華法林且INR≥2可降低NIHSS評分(odds ratio=0.24,95%CI:0.07-0.85,P=0.027),服用華法林可減少房顫腦卒中患者的住院費(fèi)用,(β=-0.10,95%CI:-0.18~-0.02,P=0.018),差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:服用華法林且INR≥2的心房顫動(dòng)患者若發(fā)生腦卒中其嚴(yán)重程度及住院費(fèi)用均小于未服用華法林的患者。
[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 鹵4.4 vs 7.9 鹵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，

本文編號：1468560