中译英

    虽然有证实华法林可明显降低脑卒中的发病率，然而在我国房颤患 者的华法林使用率并不高，原因多为监测凝血不 便和担忧出血危险，在使用华法林时，需要定期检测INR值，且其稳定剂量常受到到患者饮食、 疾病状态、共用药物及基因因素的影响[8]，如在 吴军[4]与徐建然[5]均在研究中发现在华法林应用中要严密监测INR值，保持在较低的安全强度范 围，方可避免出血并发症，达到预防老年房颤脑卒中的目的。另外，许多患者不能耐受，不了解华法林服用注意事项，缺乏定期 检测INR意识，使多数医生存在顾虑[9]。本次研 究进一步证实华法林预防房颤患者脑血栓栓塞的 疗效和安全性，增加医师应用华法林的信心以及为日后如何正确合理使用提供依据。可以通过沟 通让患者充分了解其益处和注意事项，才能使其 在临床上发挥最大的功效，减少并发症，减少脑栓塞的发生率，使更多患者受益。房颤是临床中较为常见的心律失常，有增高 脑卒中的风险，该风险可通过CHADS2评分进行 评估。即使华法林有可能会增加出血风险，其仍被研究者在CHADS2评分超过2时推荐为预防性治疗药物。然而，在脑卒中事件尤其是缺血性脑 卒中事件中，华法林能否在非瓣膜性老年房颤患 者中起到预防作用，国内外研究尚未有一致性定论。本研究表明，华法林在非瓣膜性老年房颤患 者中具备干预缺血性脑卒中发生的作用。

         Although evidence has demonstrates that warfarin can significantly reduce the incidence of stroke, the use of warfarin in atrial fibrillation patients is not prevalent in our country. The reasons mainly include inconvenient monitoring of coagulation and the concerns on the risk of bleeding. Use of warfarin requires regular detection of INR values. The stable dosage is often influenced by patient’s diet, disease status, concomitant medicines and genetic factors [8]. Forexample, Jun Wu [4] and Jianran Xu [5] both found in their research that a close monitoring of INR value was required during the use of warfarin, and that warfarin should be maintained at a low safety intensity range to avoid bleeding  and to achieve the goal of stroke prevention in elderly atrial fibrillation. In addition, many patients are intolerable, unaware of the precautions, or unaware of regular monitoring of INR, making most doctors concerned about the use of warfarin [9]. This study further demonstrated the therapeutic effect and safety of warfarin in prevention of ischemic stroke in atrial fibrillation patients, which enhanced the confidence of warfarin use by physicians and provided basis for reasonable use. Communications to allow patients to fully understand the benefits and precautions may make warfarin play the greatest role in clinical practice, reduce complications and the incidence of cerebral embolism, and thus make more patients benefit from the use. Atrial fibrillation is a common type of arrhythmia in clinical practice, with an increased risk of stroke, which can be assessed by CHADS2 scores. Although warfarin is likely to increase the risk of bleeding, it is recommended by the investigator to be a prophylactic therapy when the CHADS2 score was higher than 2. However, there is no consistent conclusion in domestic or abroad studies, regarding whether warfarin can prevent stoke events, especially ischemic stroke, in elderly patients with nonvalvular atrial fibrillation. This study showed that warfarin can prevent ischemic stroke in elderly nonvalvular atrial fibrillation patients.