焦虑/抑郁状态影响心脏瓣膜术后华法林抗凝质量的回顾性研究  

Retrospective study on the effect of anxiety or depression on the quality of warfarin anticoagulation after heart valve surgery

作　　者：史金平 唐亚娟 张琰 白娟 洪术霞 路小寒 王立珍 SHI Jin-ping;TANG Ya-juan;ZHANG Yan;BAI Juan;HONG Shu-xia;LU Xiao-han;WANG Li-zhen(Department of Pharmacy,Xi’an International Medical Center Hospital,Xi’an 710100)

机构地区：[1]西安国际医学中心医院药学部,西安710100

出　　处：《中南药学》2024年第7期1915-1918,共4页Central South Pharmacy

基　　金：西安国际医学中心医院青年课题(编号:2023QN13)。

摘　　要：目的研究焦虑/抑郁状态对华法林抗凝质量的影响,以提高华法林抗凝质量。方法调取2020年1月至2023年5月到某医院就诊,行心脏瓣膜置换术并规律口服华法林,且定期复诊的患者病历,以是否合并焦虑/抑郁状态分为研究组与对照组,研究焦虑/抑郁状态对华法林抗凝质量的影响。结果共纳入236例患者,其中研究组35例,对照组201例,倾向性评分匹配后的结果提示:合并焦虑/抑郁状态的患者华法林剂量调整次数(3.29±1.71)、维持剂量(3.17±0.84)mg均显著高于对照组(P<0.05);且合并焦虑/抑郁状态的患者获得高抗凝质量的比例(5.71%)与治疗范围内时间百分比(26.00±21.00)%显著低于对照组(P<0.05)。结论合并焦虑/抑郁状态的患者华法林抗凝质量普遍较低,且此类患者需给予更高剂量的华法林才能使国际标准化比值达到稳定。Objective To determine the influence of anxiety or depression on the quality of warfarin anticoagulation,and timely intervene to improve the quality of warfarin anticoagulation.Methods From January 2020 to May 2023,the patients who were hospitalized for heart valve replacement and regularly took warfarin orally were divided into a study group and a control group according to whether they were accompanied with anxiety or depression.The effect of anxiety or depression on the quality of warfarin anticoagulation was measured.Results Totally 236 patients were included(35 patients in the study group and 201 patients in the control group).The propensity score matching showed that the number of dose adjustments(3.29±1.71),and the maintenance dose of warfarin(3.17±0.84)mg for patients with anxiety or depression were higher than those in the control group(P<0.05).The proportion of patients with anxiety or depression who achieved high anticoagulation quality(5.71%)and the percentage of time within the therapeutic range(26.00±21.00)%were significantly lower than those of the control group(P<0.05).Conclusion The quality of warfarin anticoagulation in patients with anxiety or depression is generally low,and such patients need to receive higher doses of warfarin to stabilize the international normalized ratio.

关 键 词：心脏瓣膜置换 焦虑/抑郁状态 华法林 抗凝质量 治疗范围内时间百分比 

分 类 号：R973[医药卫生—药品]