云贵高原地区老年心脏生物瓣膜置换术后华法林抗凝治疗130例的近期效果  

Recent effect of warfarin anticoagulant therapy for 130 elderly cases after heart biological valve replacement in Yunnan-Guizhou plateau

作　　者：刘寅强[1] 陶杰[1] 杨百晖[1] 夏健明[1] 张学玉[1] 张桂敏[1] 

机构地区：[1]昆明医科大学第一附属医院心血管外科,650032

出　　处：《实用医学杂志》2014年第9期1490-1492,共3页The Journal of Practical Medicine

基　　金：云南省创新团队计划资助项目(编号:2011CI137)

摘　　要：目的：探讨云贵高原地区65岁以上老年患者心脏生物瓣膜置换术后合理抗凝治疗的应用情况．研究老年生物瓣膜置换后抗凝治疗的标准。方法：通过回顾性研究方法收集病例近期资料．对130例≥65岁的心脏生物瓣膜置换后患者采用低强度抗凝治疗标准INR（1．5-2．5）．达到稳定抗凝状态后对不同术式患者的华法林剂量、抗凝标准进行比较；研究INR均值频数、华法林剂量均值频数：比较高危因素患者与常规患者INR值、华法林剂量差异。结果：在患者达到稳定抗凝状态后，不同手术组间INR值、华法林剂量比较差异无显著性（P〉0．05）；患者频数图显示INR值为1．94±0．50，每日华法林剂量为（2．45±0．82）mg：高危患者抗凝稳态下INR值、华法林日平均剂量与非高危患者间比较差异无显著性（P〉0．05）；随访期间。栓塞和一般性出血发生率均为0．77％。结论：近期研究结果表明，低强度抗凝INR值（1．5～2．5）可作为云贵高原地区老年患者生物瓣膜置换后合理抗凝的标准．观察抗凝效果满意。Objective To investigate the reasonable anticoagulant therapy for patients over sixty five years old in Yunnan-Guizhou plateau after heart biological valve replacement, and study the standard of reasonable anticoagulant therapy. Methods We collected the recent cases by retrospective way . Low-intensity anticoagulation standard INR （1.5 ±2.5） was used on 130 patients over sixty five years old. The warfarin dose and anticoagulation INR values in different surgery operation were compared when the patients reached the stable anticoagulation status. The frequency of INR values and warfarin dosage were studied. The differences between the patients with high risk factors and the ordinary patients without the high risk factors in INR values and warfarin dosage were investigated. Results The [NR values and warfarin doses showed no significant difference （P 〉 0.05 ） in different operation groups when they reached stable anticoagulation status. The INR values was 1.94 ± 0.50 and the daily warfarin dose was （2.45 ± 0.82）mg/d. No significant differences in INR values and warfarin doses were found between the high- risk group and the general group （P 〉 0.05） in steady-state. During follow-up, both the incidence rate of thrombosis and general bleeding were 0.77%. Conclusion The precent study showed that the low-intensity anticoagulation INR values （ 1.5 - 2.5） can be the standard of reasonable antieoagulation in Yunnan-Guizhou plateau after heart biological valve replacement with satisfactory anticoagulant effect.

关 键 词：心脏瓣膜 人工 抗凝治疗 华法林 云贵高原 

分 类 号：R654.2[医药卫生—外科学]