Ricou F J, Arroyo J F
Centre de cardiologie, Hôpital cantonal universitaire de Genève.
Praxis (Bern 1994). 1996 Feb 6;85(6):155-8.
Compared to the normal population, patients with atrial fibrillation are at a significantly enhanced risk for cerebrovascular insults, in particular when the fibrillation is of recent occurrence, chronic rather than paroxysmal, and when it is associated with cardiopathy. Several studies have documented the efficacy of anticoagulation in prevention of cerebrovascular insults. Aspirin may be a valid alternative in young patients without cardiopathy; however, anticoagulation is more effective in patients which have experienced thromboembolism. In elderly patients (over 75 years) the situation is unclear, because the favorable effects of anticoagulation are offset by an increased risk for intracerebral hemorrhage. The treatment must thus be individualized by assessment of a risk/benefit ratio.
与正常人群相比，房颤患者发生脑血管损伤的风险显著增加，尤其是在房颤为近期发生、慢性而非阵发性，且伴有心脏病时。多项研究已证明抗凝治疗在预防脑血管损伤方面的疗效。阿司匹林可能是无心脏病的年轻患者的有效替代药物；然而，抗凝治疗对经历过血栓栓塞的患者更有效。在老年患者（75岁以上）中情况尚不清楚，因为抗凝治疗的益处被脑出血风险增加所抵消。因此，必须通过评估风险/效益比来进行个体化治疗。
