摘要
目的了解华法林在心血管门诊患者的临床应用情况,为临床药师参与抗凝治疗管理提供参考。方法利用医院信息系统(hospital information system,HIS)查询2015年12月广东省人民医院心血管门诊处方中含"华法林"的患者资料,并对患者年龄、病种、合并用药、国际标准化比值(international normalized ratio,INR)监测依从性等进行回顾性分析。结果入选华法林抗凝治疗患者677例,病种以心脏瓣膜病、换瓣术后和心房颤动为主,占77.10%。共监测INR 2 031次,INR在1.8~2.5占49.53%;其中439例(64.84%)服用华法林维持剂量为(3.48±1.24)mg/d,INR达标率为51.86%;238例(35.16%)处于剂量调整期,INR达标率为45.24%;其中229次联用了与华法林存在相互作用的药物,主要为抗心律失常药、调脂药、抗血小板药及益气活血类中成药。INR达标率与患者年龄、病种和联合用药有关(P<0.05)。结论患者年龄、病种、联合用药对INR达标率有影响,应尽可能减少华法林剂量调整期间的联合用药,加强对华法林抗凝治疗患者的用药教育。
Objective To investigate the application of warfarin in cardiovascular outpatients ,and provide reference for the clinical pharmacist participating in anticoagulation treatment. Methods Clincial data of patients with warfarin anticoagulation treatment guided by cardiovascular disease clinic doctors during December 2015 in Guangdong General Hospital were inquired by hospital information system （HIS）. Their age,disease,international normalized ratio （INR）,concomitant medication and monitor compliance were respectively analyzed. Results Among the 677 patients with warfarin anticoagulation treatment ,77.10% suffered valvular heart disease ,valvular surgery or fibrillation atrial. INR was monitored 2031 times and the value between target 1.8-2.5 accounted for 49.53%. There were 439 patients taked warfarin maintenance dose of（3.48±1.24）mg/d,and their INR target rate was 51.86%. There were 238 patietns adjusting their warfarin dose ,and their INR target rate was 45.24%. There were 229 patients using interactive drugs with warfarin ,such as antiarrhythmia drugs ,lipid-lowering drugs ,antiplatelet drugs and Chinese medicine for supple-menting qi and activating blood circulation. INR target related to patients＆#39; age,disease and concomitant medication（P〈0.05）. Conclusions Patients＆#39; age,disease and concomitant medication affecte INR target,so it is important to reduce concomitant medication as far as possible in warfarin dose adjustment ,and strengthen medication education to outpa-tients with warfarin anticoagulation treatment.
出处
《岭南心血管病杂志》
2017年第5期566-570,共5页
South China Journal of Cardiovascular Diseases
基金
广州市科技计划项目(项目编号:201509010012)
关键词
心血管门诊
华法林
剂量调整
联合用药
国际标准化比值
cardiovascular disease clinic
warfarin
dose adjustment
concomitant medication
international normal-ized ratio
