摘要
目的探讨人工机械瓣膜置换术后抗凝治疗在重庆地区人群中的治疗效果，初步建立重庆地区的换瓣患者术后抗凝治疗的临床资料库。方法对133例重庆地区人工机械瓣膜置换术后患者采用低强度抗凝治疗标准，待其达到稳定抗凝状态且无抗凝相关并发症后，对抗凝效果进行回顾性分析，初步建立重庆地区术后抗凝标准。结果在患者达到稳定抗凝状态后，INR值为（1．80±0．46）；每日华法林剂量为（2．69±1．02）mg，不同手术组的抗凝指标均达到预期抗凝指标。重庆地区主动脉瓣置换术（AVR）的INR目标值设置为1．6（1．5—2．0），二尖瓣置换术（MVR）及双瓣置换术（DVR）的INR预计值设置为1．8（1．6～2．3）、冠状动脉搭桥术同期行MVR（MVR＋CABG）的INR预计值设置为2．0（1．8—2．3）、Bentall手术（人造升主动脉置换＋MVR）INR预计值设置为2．2（1．8～2．5），总体INR预期值1．5～2．5。结论本研究抗凝指标结果符合重庆地区人工机械心脏瓣膜置换术后患者的抗凝治疗强度标准。
Objective To define the optimal intensity of oral anticoagulant therapy in patients with mechanical heart valve prostheses in Chongqing. Methods All the 133 patients who had undergone valve replacement in our hospital were involved in this study. Warfarin therapy at an initial dose of 2.5 mg began when drainage tube was removed 24 or 48 h after operation. After oral anticoagulant therapy for 3 months, the relationship between the intensity of anticoagulant effect and dose of warfrain were analyzed. Then the optimal intensity of anticoagulant effect for the patients in Chongqing was defined. Results The final mean value of international normalized ratio （INR） was （ 1.80 ± 0.46）, and the mean dose of Warfain was recommended as （2.69 ± 1.02） mg daily. Conclusion INR for aortic valve replacement （AVR） patients is 1.65 （1.5 - 2.0）, for MVR patients is 1.87 （ 1.6 -2.3）, for DVR patients is 1.65 （ 1.6 -2.3）, for MVR and CABG patients is 1.94 （ 1.6 - 2.3）, and for Bentall patients is 1.86 （ 1.8 - 2.5）. The optimal intensity of anticoagulant effect for the patients in Chongqing with mechanical heart valve prostheses is INR from 1.5 to 2.5, which could prevent thrombolic events and reduce the incidence of hemorrhagic events.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2008年第7期647-649,共3页
Journal of Third Military Medical University
