下肢深静脉血栓患者口服华法林初始剂量探讨  

An investigation of initial doses of oral warfarin in treatment of patients with lower extremity deep vein thrombosis

作　　者：陈洪碧[1] 蒋岚杉[1] 王雪钢[1] 白斗[1] 武少辉 张效杰[1] 

机构地区：[1]四川省绵阳市中心医院血管外科,四川绵阳621000

出　　处：《实用医院临床杂志》2014年第5期170-171,共2页Practical Journal of Clinical Medicine

摘　　要：目的：探讨不同年龄的下肢深静脉血栓（ deep venous thrombosis ，DVT）患者口服华法林的最佳初始剂量。方法我科2012年1月至2013年10月收治112例急性下肢深静脉血栓患者，根据患者年龄分为甲、乙、丙三组，并给予不同的初始剂量，甲组27例（＜51岁，初始剂量3.75 mg），乙组52例（51～70岁，初始剂量2.5 mg），丙组33例（＞70岁，初始剂量1.25 mg）。通过监测国际化标准比值（ INR）调整华法林用量，监测三组患者INR达到2.0～3.0时的时间及华法林维持剂量。结果 INR达到2.0～3.0时，甲组用时（7.2±1.2）d，华法林剂量为（4.23±0.82）mg；乙组用时（9.3±1.5）d，华法林剂量为（4.05±0.64）mg；丙组用时（9.7±0.7）d，华法林剂量为（3.32±0.45）mg。结论对于不同年龄的急性DVT患者，可选择不同的华法林初始剂量，使患者更快、更安全的达到维持剂量。Objective To explore the optimal initial doses of oral warfarin in treatment of patients with deep venous thrombosis （ DVT） in different ages .Methods One hundred and twelve patients with acute DVT were received and cured in our department from January 2012 to October 2013.The patients were divided into A ,B and C groups according to the patient＇s age.The three groups were given different initial dose.The group A （n =27 with age 〈51 years old） was give an initial dose of 3.75 mg.The group B （n =52 with age 51-70 years old） was given an initial dose of 2.5 mg.The group C （n =33 with age〉70 years old） was given an initial dose of 1.25 mg.The warfarin doses were adjusted through monitoring INR .The time of reaching INR 2.0-3.0 and warfarin maintenance do-ses were monitored.Results The time of reaching INR 2.0-3.0 was（7.2 ±1.2）d in the group A,（9.3 ±1.5）d in the group B and （9.7 ±0.7）d in the group C,respectively.The maintenance warfarin doses were （4.23 ±0.82）mg in the group A,（4.05 ±0.64）mg in the group B and （3.32 ±0.45）mg in the group C,respectively.Conclusion For acute DVT patients,an initial dose of warfarin should be selected according to ages of patients so that patients could reach the maintenance doses faster and safer .

关 键 词：下肢深静脉血栓 华法林 抗凝 

分 类 号：R658.3[医药卫生—外科学] R654.3[医药卫生—临床医学]