华法林个体化治疗独立指南的现状分析  

Analysis of the current status of independent guidelines for warfarin therapy

作　　者：况赟 宋珑[2] 孙媛媛 郭成贤[1] 刘立明[2] 阳国平[1] KUANG Yun;SONG Long;SUN Yuan-yuan;GUO Cheng-xian;LIU Li-ming;YANG Guo-ping(Center of Clinical Pharmacology,The Third Xiangya Hospital,Central South University,Changsha 410013,Hunan Province,China;Department of Cardiothoracic Surgery,The Second Xiangya Hospital,Central South University,Changsha 410011,Hunan Province,China)

机构地区：[1]中南大学湘雅三医院临床药理中心,湖南长沙410013 [2]中南大学湘雅二医院心胸外科,湖南长沙410011

出　　处：《中国临床药理学杂志》2022年第17期2084-2088,共5页The Chinese Journal of Clinical Pharmacology

基　　金：国家科技重大专项基金资助项目(2020ZX09201010);国家自然科学基金资助项目(81673519);湖南省科技重点专项基金资助项目(2020SK2010)。

摘　　要：华法林是临床应用适应症最多、循证医学证据最为充足的口服抗凝药物,但是其治疗窗窄,个体差异大,抗凝不足易血栓,抗凝过度易出血。影响华法林的因素众多,临床如何合理地应用华法林显得至关重要。目前,国内并无华法林个体化治疗的独立指南出台指导华法林用药。本文通过对国外现行指南进行分析总结和经验借鉴,并提出制定中国华法林个体化治疗独立指南的6条建议:(1)利用大样本中国人群数据建立中国人群的推荐剂量公式;(2)基于高质量数据建立的质量评分评估早期华法林抗凝效果;(3)不能获得基因型的患者推荐临床公式指导给药;(4)利用信息化系统对患者用药等进行管理;(5)增加每片0.5 mg的药物规格;(6)基于南北方人群饮食差异,制定不同目标国际标准化比值。Objective Warfarin is the oral anticoagulant with the most clinical indications and the most adequate evidence-based medical evidence,but its treatment window is narrow,individual differences are large,insufficient anticoagulation is prone to thrombosis,and excessive anticoagulation is prone to bleeding.There are many factors that affect warfarin,so how to apply warfarin rationally in clinical practice is very important.At present,there is no independent guide for individual treatment of warfarin in China to guide the use of warfarin.Based on the analysis and summary of the current foreign guidelines,this paper puts forward six suggestions for the establishment of independent guidelines for warfarin therapy in China.(1) Formulas of recommended dose for Chinese population were established using data from a large sample of Chinese population;(2) Quality scores based on high quality data were used to evaluate the early anticoagulant efficacy of warfarin;(3) Patients who cannot obtain genotypes have recommended clinical formulae to guide administration;(4) Use the information system to manage the medication of patients;(5) Increase the drug specification for warfarin(0.5 mg per piece);(6) Based on the dietary differences between the northern and southern populations,different target international standardized ratios were formulated.

关 键 词：华法林 个体化 中国 指南 

分 类 号：R973.2[医药卫生—药品]