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| 心脏瓣膜置换术后影响华法林抗凝达标的相关因素分析 |
| Analysis of Related Factors Affecting Warfarin Anticoagulation after Cardiac Valve Replacement |
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| DOI： |
| 中文关键词: 华法林 心脏瓣膜置换术 国际标准化比值 影响因素 |
| 英文关键词:Warfarin Cardiac valve replacement International normalized ratio Influencing factor |
| 基金项目:陕西省自然科学研究计划项目（编号：2018JM7053），西安交通大学第一附属医院院基金项目（编号：2018MS-21） |
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| 中文摘要: |
| 摘 要 目的：探讨心脏瓣膜置换术后使用华法林抗凝患者的国际标准化比值（INR）达标相关影响因素。 方法：应用回顾性分析方法，随机抽取某三甲教学医院2018年1~12月瓣膜置换术后使用华法林患者病例资料100份，根据出院时INR值达标情况分为达标组与未达标组，采用单因素分析及二元Logistic回归模型，对INR达标情况及其影响因素进行分析。 结果：INR值达标组39例，未达标组61例。Logistic回归分析结果显示，术后联用阿司匹林患者的INR值达标可能性低于未联用患者[OR=0.220，95%CI（0.063，0.772）]，术后联用贝那普利患者较未联用患者的INR值更可能达标[OR=2.541，95%CI（1.026，6.295）]，监测INR值次数＞5较监测次数≤5的患者INR值更可能达标[OR=7.701，95%CI（2.037，29.112）]。 结论：联用阿司匹林、联用贝那普利、监测INR值次数（＞5）是影响心脏瓣膜置换术后华法林抗凝INR值达标的主要因素，应结合相关影响因素，为临床药师指导个体化使用华法林提供初步的参考依据。 |
| 英文摘要: |
| ABSTRACT Objective: To discuss the influencing factors for reaching the target range of international normalized ratio(INR) in patients with warfarin after heart valve replacement. Methods:In retrospective study, 100 patients with warfarin after valve replacement were extracted at random in a third eaching hospital from January to December 2018. According to the INR value, it was divided into the attainment group and the non attainment group. Analysis of related factors by univariate analysis and binary logistic regression analysis. Results: There were 39 patients in the attainment group and 61 patients in the non-attainment group. Binary logistic regression analysis showed that, People given in combination with aspirin than non-combination aspirin had lower likely to reach the target range of INR (OR=0.220, 95%CI 0.063 to 0.772), and people given in combination with benazepril than non-combined benazepril had more likely to reach the target range of INR (OR=2.541, 95%CI 1.026 to 6.295), and people monitoredthe number of INR values ＞5 than the number≤5 had more likely to reach the target range of INR (OR=7.701, 95%CI 2.037 to 29.112).Conclusion:Combined aspirin or benazepril, and monitor the number of INR values (＞5) were the main affecting warfarin anticoagulation for reaching the target range of INR after cardiac valve replacement. It should provide a preliminary reference for clinical pharmacists to guide individualized use of warfarin. |
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