目的 比较规范的华法林抗凝和抗血小板治疗对心源性脑栓塞患者心理及生活质量的影响.方法 连续纳入心源性脑栓塞患者201例,其中华法林抗凝组107例,抗血小板治疗组94例.采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和SF-36健康调查量表评价两组患者第3 d及第1、3、6、9、12个月时的焦虑、抑郁、生活质量水平.结果 抗凝组第12个月的SAS、SDS评分显著低于第3 d(t＝10.142,t＝9.704;均P＜0.001).与抗血小板组比较,抗凝组第3、6、9、12个月SAS和SDS评分显著下降(均P＜0.001).与起病第3 d比较,抗凝组SF-36健康调查量表第12个月 PCS、MCS评分显著升高(t＝ －32.426,t＝ －33.549;均P＜0.001);抗血小板组第12个月 MCS评分差异无统计学意义(t ＝ －0.613,P＝0.541),PCS评分显著升高(t＝ －25.994,P＜0.001).与抗血小板组比较,抗凝组第3、6、9、12个月MCS评分均显著升高(均P＜0.01).结论 规范的华法林抗凝治疗、定期在抗凝门诊就诊能显著改善心源性脑栓塞患者的焦虑、抑郁情绪,有利于生活质量提高.%Objective To compare the effect between the standardized warfarin anticoagulation and antiplatelet therapy on the psychology and quality of life in patients with cardiogenic cerebral embolism.Methods Two hundred and one patients with cardiogenic cerebral embolism were enrolled in this study,including 107 subjects in warfarin anticoagulant group and 94 subjects in antiplatelet therapy group. All subjects were assessed for anxiety,depression, and quality of life at 3rd day,1st,3rd,6rd,9rd,and 12th months using the self-rating anxiety scale (SAS),self-rating depression scale (SDS)and the 36-item short form health survey (SF-36).Results SAS and SDS scores in anticoagulation group at 12th months were significantly lower than those at 3rd days(t＝10.142,t＝9.704;all P＜0.001). Compared with antiplatelet therapy group,SAS and SDS scores in anticoagulation group at 3rd,6th,9th, 12th month were significantly lower (all P＜0.001). Compared with 3rd day,PCS and MCS scores of SF-36 at 12th month were significantly higher in anticoagulation group(t＝ －32.426,t＝ －33.549;all P＜0.001). Compared with 3rd day, there was no statistical significance MCS score at 12th month in antiplatelet therapy group (t＝ －0.613,P＝0.541),and PSC at 12th month were significantly higher (t＝ －25.994,P＜0.001). Compared with antiplatelet therapy group,MCS score in anticoagulation group at 3rd,6th,9th,12th month were significantly higher (all P＜0.01).Conclusion Standardized warfarin anticoagulant in the anticoagulant clinic can significantly reduce anxiety and depression,and improve the quality of life in patients with cardiogenic cerebral embolism.
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