机械心脏瓣膜替换术后低强度抗凝5年随访  

Anticoagulation with low intensity after mechanical cardiac valve replacement: five-year follow-up

作　　者：褚银平[1] 程金莲[2] 刘爱军[3] 孙彦龙[3] 赵民[4] 

机构地区：[1]山西省人民医院,山西省太原市030012 [2]山西医科大学第一医院 [3]山西医科大学第二医院心胸外科 [4]中铁三局集团中心医院

出　　处：《中国心血管病研究》2005年第10期781-783,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨机械心脏瓣膜替换术后低强度抗凝的可行性。方法回顾性分析63例瓣膜替换术患者5年的临床资料,其中男性27例,女性36例;年龄17～61(43.8±6.7)岁。二尖瓣替换术(MVR)42例,主动脉瓣替换术(AVR)5例,二尖瓣和主动脉瓣双瓣替换术(DVR)15例,三尖瓣替换术(TVR)1例。共用机械心脏瓣膜78枚,其中北京GK-Ⅱ47枚,意大利SorinBicarbon20枚,美国Medtronic-Hall11枚。心功能Ⅱ级6例、Ⅲ级28例、Ⅳ级29例。结果无早期和远期死亡病例,随访183个病人年,心功能恢复到Ⅰ级和Ⅱ级者占98.4%。在PTR1.2～1.7,INR1.2～2.5范围内,无血栓栓塞和瓣膜相关并发症。抗凝有关的出血3例(1.6%/病人年),均发生在瓣膜替换术后1年内,并不需要住院治疗。结论机械心脏瓣膜替换术后低强度抗凝是可行的,一般PTR1.2～1.7,INR1.2～2.5左右。Objective To evaluate anticoagulation with low intensity after mechanical cardiac valve replacement. Methods A prospective clinical 5-year follow-up was performed in 63 patients who underwent mechanical cardiac valve replacement. 27 men and 36 women, mean age 43.8 years. Forty two patients had the mitral valve replaced, 5 the aortic valve, 1 the tricuspid valve, and 15 mitral and aortic valves. There were 78 mechanical valves replaced, 47 GK-Ⅱ, 20 Sorin Bicarbon, 11Medtrenic-Hall. Results There was no dead case. Follow-up lasted 183 patient-years. Three patients had episodes of anticoagulant-related hemorrhage （1.6 patient-years） during one year post valve replacement. Embolic complications and valve-related event was freedom during follow-up. Conclusion Anticoagulant with low intensity would he feasible after mechanical cardiac valve replacement in Chinese population.

关 键 词：机械心脏瓣膜 抗凝药 

分 类 号：R654.2[医药卫生—外科学]