华法林对心脏瓣膜置换术后患者血液系统的影响  

Effect of Warfarin on the Blood System in the Cardiac Valve Replacement Patients

作　　者：郭丽萍[1] 史香芬[2] 袁冬冬[1] GUO Liping;SHI Xiangfen;YUAN Dongdong(Department of Pharmacy,Zhengzhou 7th People’s Hospital,Zhengzhou 450016,China;Department of Pharmacy,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州市第七人民医院药学部,河南郑州450016 [2]郑州大学第一附属医院药学部,河南郑州450052

出　　处：《河南医学研究》2025年第5期904-907,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230737);郑州市医疗卫生领域科技创新指导计划项目(2024YLZDJH236)。

摘　　要：目的探讨华法林对心脏瓣膜置换术后患者血液系统的影响。方法本研究为回顾性分析,收集郑州市第七人民医院2020年12月至2021年12月门诊诊疗的598例心脏瓣膜置换术后患者的临床资料,根据是否长期服用华法林分为研究组(299例)和对照组(299例),其中研究组为长期服用华法林6个月以上,对照组为未服用或停用华法林1个月以上。采用t检验或χ^(2)检验,比较两组患者的基线临床特征数据、白细胞计数、中性粒细胞计数、红细胞计数、淋巴细胞计数、血小板计数、血红蛋白水平。结果两组间性别、年龄、肝肾功能等临床基线数据差异无统计学意义(P>0.05);研究组红细胞计数水平、血红蛋白浓度、淋巴细胞计数水平分别为(4.04±0.56)×10^(9)L^(-1)、(120.95±18.14)g·L^(-1)、(1.52±0.57)×10^(9)L^(-1),以上3个指标低于对照组,差异有统计学意义(P<0.05),其余血常规观察指标差异无统计学意义(P>0.05)。结论华法林会对患者的血液系统产生不良影响,主要表现在红细胞数目、血红蛋白水平和淋巴细胞数目明显下降。基于华法林在临床的高频使用,临床医师和药师应关注和警惕长期服用华法林出现的血液系统不良反应,定期监测血常规,保障患者用药安全。Objective To investigate the effect of warfarin on the blood system of patients after cardiac valve replacement.Methods This study was a retrospective analysis.Clinical data of 598 patients after cardiac valve replacement in the Outpatient Department of Zhengzhou Seventh People’s Hospital from December 2020 to December 2021 were collected.They were divided into study group(299 cases)and control group(299 cases)according to whether they took warfarin for a long time.The study group took warfarin for more than 6 months,and the control group did not take or stopped warfarin for more than 1 month.t test orχ^(2)test were used to compare the baseline clinical characteristics,white blood cell count,neutrophil count,red blood cell count,lymphocyte count,platelet count,and hemoglobin concentration of the two groups.Results There were no significant differences in gender,age,liver and kidney function between the two groups(P>0.05).The levels of red blood cell count,hemoglobin concentration and lymphocyte count in the study group were(4.04±0.56)×10^(9)L^(-1),(120.95±18.14)g·L^(-1)and(1.52±0.57)×10^(9)L^(-1),respectively,which were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in other blood routine observation indexes(P>0.05).Conclusion Warfarin will affect the blood system of patients with valvular heart disease,mainly manifested in the decrease of red blood cells,and the significant increase in the concentration of hemoglobin and the number of lymphocytes.Based on the high frequency of warfarin use in clinical practice,clinicians and pharmacists should pay attention to and be alert to the adverse reactions of blood system caused by long-term warfarin use,and regularly monitor blood routine to ensure the safety of drug use for patients.

关 键 词：心脏瓣膜置换术 血液系统 华法林 红细胞计数 血红蛋白 淋巴细胞计数 

分 类 号：R917[医药卫生—药物分析学]