摘要
目的分析房颤患者服用华法林抗凝质量的影响因素及其与不良事件的关系。方法对251例长期服用华法林抗凝的房颤患者,进行国际标准化比值(INR)的收集和出血、栓塞及死亡事件的跟踪随访。以INR在治疗目标范围内的时间百分比(TTR)来反映华法林抗凝质量。结果251例患者平均TTR值仅为32.4%,只有12.0%的患者获得高水平抗凝质量(TTR≥65%)。Logistic回归分析显示年龄<60岁(OR=2.911)和脑卒中史(OR=5.608)是低质量抗凝的影响因素。不同抗凝质量组不良事件发生率比较,差异无统计学意义(均P>0.05),但不良事件均发生在TTR<65%的患者。结论房颤患者服用华法林抗凝质量差,远低于有效的抗凝水平。医护人员需对年龄<60岁、脑卒中史和TTR<65%的患者加强抗凝管理,改善抗凝质量,减少不良事件的发生。
Objective To explore factors associated with the quality of warfarin anticoagulation,and the relationship between quality of warfarin anticoagulation and adverse events in patients with atrial fibrillation.Methods Totally,251 patients with atrial fibrillation(AF)on warfarin therapy were followed up,and data such as international normalized ratios(INRs)and adverse events including bleeding,embolism and deaths were collected during follow-up.Quality of warfarin anticoagulation was reflected as time in therapeutic range(TTR).Results The included patients had an average TTR of 32.4%,and only 12.0%enjoyed a high quality of warfarin anticoagulation(TTR≥65%).Logistic regression analysis showed that,age<60 years(OR=2.911)and previous stroke(OR=5.608)were associated with poor quality of warfarin anticoagulation.The incidence rates of adverse events had no significant differences between the high quality and low quality groups.However,all types of adverse events occurred in the low quality group.Conclusion The quality of warfarin anticoagulation in patients with AF was poor,being far below an effective anticoagulation level.To improve the quality of warfarin anticoagulation and reduce the incidence rates of adverse events,medical staffs should strengthen management of anticoagulation for patients under 60 years of age,those with previous stroke and those with TTR<65%.
作者
伍珊珊
黄远平
王耀利
谢铄
王丽姿
Wu Shanshan;Huang Yuanping;Wang Yaoli;Xie Shuo;Wang Lizi(Department of Cardiology,Zhujiang Hospital,Southern Medical University,Guangzhou 510280,China)
出处
《护理学杂志》
CSCD
北大核心
2019年第11期9-12,共4页
Journal of Nursing Science
