口服华法林患者凝血因子Ⅶ活性的变化

Changes of Factor Ⅶ Coagulant Activity in Oral Warfarin Patients

目的研究口服华法林患者与肝衰竭患者比较 PT-INR 和凝血因子Ⅶ活性的变化。方法 65例风湿性心脏病换瓣术后口服维持量抗凝治疗患者分适度抗凝组 INR 1.5～2.8 31例,过度抗凝组 INR＞2.8 34例患者和肝衰竭 35例患者,测定其凝血酶时间(PT)、国际标准化比率(INR)、凝血酶原时间活动度(PTA)、凝血因子Ⅶ活性(FⅦ：C)。结果肝衰竭患者、适度抗凝和过度抗凝患者 PT 分别是20.94±10.94s、22.18±2.93s 和38.7±4.45 s。FⅦ：C 分别是 34.91±14.96%、31.58±9.35%和12.44±2.84%。肝衰竭患者 PTA 为74.53±23.69%。适度抗凝和过度抗凝组的 INR 分别是2.05±0.29和3.36±0.39。PT 和 FⅦ：C 在肝衰竭组和适度抗凝组比较无统计学差异,INR 和 FⅦ：C 在适度抗凝组和过度抗凝组有明显差异。结论华法林因抑制维生素 K 依赖因子,使 FⅦ：C 降低,而肝衰竭患者是肝合成维生素 K 依赖因子障碍,使 FⅦ：C 降低。随着 INR 的增高,FⅦ：C 降低。FⅦ：C 在高 INR 和低 INR 有明显的相关性。

Objective To study the changes of prothrombin time （PT）-international normalized ratio （INR） and factor Ⅶ coagulant activity （FⅦ： C ） in oral warfarin patients and compring with liver failure pateints. Methods PT-INR, PTA and FⅦ： C were tested is 65 patients receiving oral warfarin after valvula prosthesis for rheumatic heat disease,which were divided into suitable anticoagulation （INR 1.5～2.8 ） and over anticoagulation （ INR 〉 2.8 ） and 35 patients with liver failure. Results PTs in groups of liver failure, suitable anticoagulation and over anticoagulation were 20.94±10.94 seconds,22.18±2, 93 s and 38.7±4.45 s respectively, FⅦ： Cs were 34.91±14.96% ,31.58±9.35% and 12.44±2.84% respectively. PTA in liver failure group were 74.53±23.69%. INR in suitable and over anticoagulation groups were 2.05±0.29 and 3.36±0.39 respectively. There is no statistic differences of PT and FⅦ： C in liver failure groups and suitable anticoagulation group and there is significant statistic difference of INR and FⅦ： C in suitable and over anticoagulation group. Conclusion As the warfair inhibites vitamin K dependent factors, FⅦ： C reduced and as hepatic synthetic dysfunction in liver failure, FⅦ： C reduced. The FⅦ： C decreased with INR inerased, there is a significances correlation in FⅦ： C in high INR and low INR.