苯溴马隆与华法林合用致房颤患者国际标准化比值升高一例报告

Benzbromarone combining with warfarin induced elevated international normalized ratio in a patient with atrial fibrillation

1例77岁男性患者,因高血压病、慢性阻塞性肺疾病急性加重期、双下肢凹陷性水肿入院治疗,入院后给予强心,降压治疗,利尿降低心脏负荷并改善水肿,同时给予抗感染对症治疗。患者4年前确诊"心房纤颤",一直规律服用华法林(po,1.5 mg,qd),入院后第2天测得国际标准化比值(INR)1.35,住院期间因尿酸偏高,入院后第33天加服苯溴马隆(po,50 mg,qd)降尿酸治疗。服用苯溴马隆后第3天上午INR升至3.41,下午升至3.71。第4天停用苯溴马隆,停用2 d后INR降至2.1。

A 77-year-old male patient was admitted to our hospital due to hypertension,acute exacerbation of chronic obstructive pulmonary disease,pitting edema of lower limbs.After admission, he received cardiotonic and antihypertensive treatment as well as diuretic therapy to reduce cardiac load and improve the edema,and anti-infectiontreatmentwas included.He was diagnosed as atrial fibrillation 4 years ago,and received warfarin therapy（po,1.5 mg,qd）regularly.The second day after admission,his international normalized ratio（INR）was 1.35,and the uric acid was higher than usual during hospital stay.On day 33 of admission,benzbromarone 50 mg daily was added to reduce uric acid.On the third day after taking benzbromarone,his INR was 3.41 in the morning,and increased to 3.71 in the afternoon.The fouth day, benzbromarone was stopped, and INR fell to 2.1 two days later.