华法林和利伐沙班对育龄女性异常子宫出血的影响  

Effects of warfarin and rivaroxaban on abnormal uterine bleeding in female patients of childbearing age

作　　者：戴婷婷 肖笛[1] 黄琪[1] 尹桃[1] DAI Ting-ting;XIAO Di;HUANG Qi;YIN Tao(Department of Pharmacy,Xiangya Hospital Central South University,Hunan Changsha 410008,China)

机构地区：[1]中南大学湘雅医院药学部,湖南长沙410008

出　　处：《中国医院药学杂志》2023年第6期669-673,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:了解华法林、利伐沙班对非妊娠育龄女性异常子宫出血(abnormal uterine bleeding,AUB)的影响,为服用口服抗凝药的女性患者提供参考。方法:通过回顾性队列研究,选取中南大学湘雅医院2021年1月至8月住院且年龄为14~50岁的育龄女性患者,采用电话和门诊随访的方式以月经周期的频率、规律性、经期长度、经期出血量4个要素为观察指标,获取患者异常子宫出血情况,研究华法林、利伐沙班对女性AUB的影响。结果:共纳入463名患者。华法林、利伐沙班和对照组中AUB的总体发生率分别是41.2%、49.4%、19.0%。3组患者AUB的总发生率、经期延长的发生率、月经过多的发生率和月经过少的发生率间差异有统计学意义,但华法林和利伐沙班AUB的总发生率差异无统计学意义(P=0.092)。对于子宫出血的延长天数:华法林平均延长3.9(1~10)d,利伐沙班平均延长6.4(3~13)d。华法林组患者AUB发生的相关性分析中,只有BMI(P=0.030)和服药前经期长度(P=0.021)这两个自变量显著。利伐沙班组患者,只有年龄(P=0.041)、BMI(P=0.025)和服药前经期长度(P=0.004)这两个自变量显著。结论:华法林和利伐沙班AUB的总发生率无差异,但高于未服用口服抗凝药物的患者。利伐沙班延长子宫出血的天数长于华法林。服用华法林的患者AUB的发生与BMI和服药前经期长度相关,服用利伐沙班的患者AUB的发生与年龄和BMI、服药前经期长度相关。OBJECTIVE To understand the effects of warfarin and rivaroxaban on abnormal uterine bleeding(AUB),and to provide reference for non-pregnant women of childbearing age to choose oral anticoagulants.METHODS Through retrospective cohort study,female patients of childbearing age who were hospitalized from January to August,2021 in Xiangya Hospital Central South University and aged from 14 to 50 years were selected.The frequency,regularity,menstrual length and menstrual bleeding of menstrual cycle were taken as observation indicators by telephone and outpatient follow-up.Warfarin and rivaroxaban’s effect on AUB was studied.RESULTS A total of 463 patients were enrolled.The overall incidence of AUB in warfarin,rivaroxaban,and control groups was 41.2%,49.4%,and 19.0%,respectively.The overall incidence of AUB in the three groups,the incidence of menstrual prolongation,the incidence of menorrhagia,and the incidence of menorrhagia were significant difference.There was no significant difference in the overall AUB incidence of warfarin and rivaroxaban(P=0.092).The number of days of uterine bleeding was extended by an average of 3.9(1 to 10)days for warfarin and 6.4(3 to 13)days for rivaroxaban.In the correlation analysis of AUB occurrence in the warfarin group,only the two independent variables of BMI(P=0.030)and premenstrual length(P=0.021)were significant.In the rivaroxaban group,only the two independent variables,age(P=0.041),BMI(P=0.025),and premenstrual length(P=0.004)were significant.CONCLUSION There is no difference in the overall AUB incidence of warfarin and rivaroxaban,but higher than those who do not take oral anticoagulant drugs.rivaroxaban prolongs the number of days of uterine bleeding longer than warfarin.The appearance of AUB in patients taking warfarin was associated with BMI and the length of the premenstrual period.The appearance of AUB in patients taking rivaroxaban was associated with age and BMI,and the length of the premenstrual period.

关 键 词：口服抗凝药物 异常子宫出血 月经 不良反应 

分 类 号：R973.2[医药卫生—药品]