华法林血浆浓度的测定在患者出院前后抗凝监测中的作用比较

SIGNIFICANCE OF WARFARIN PLASMA CONCENTRATION IN IN-PATIENT AND OUT-PATIENT'S ANTICOAGULATION MONITORING

目的探讨华法林血浆药物浓度的动态变化在心脏机械瓣膜置换术后抗凝监测中的临床意义。方法随机选择30例风湿性心脏病行机械瓣膜置换术的患者,同步测定华法林血浆药物浓度、国际标准比值(international normalized ratio,INR)、凝血酶原时间(prothrombin time,PT)和华法林服用剂量的动态变化,同时观察抗凝并发症的发生情况。结果①血浆华法林药物浓度在患者出院后3个月、6个月、1年保持相对稳定,与出院前相比无显著变化(P>0.05)。②INR和PT在患者出院前后相比无显著变化(P>0.05)。结论华法林血浆药物浓度灵敏而稳定,其与INR及PT等抗凝监测指标结合有助于提高抗凝监测的准确性,减少抗凝并发症的发生。

Objective To study the clinical significance of Warfain plasma concentration in oral anticoagulation monitoring following mechanical heart valve replacement. Methods Thirty patients following mechanical heart valve replacement were chosen randomly. They all had rheumatic heart disease. Plasma concentration of Warfarin, international normalized ratio （INR）, prothrombin time （PT） and oral dosage of Warfarin were determined respectively. At the same time, the clinical complications, such as blooding and thromboembolism were observed. Results ①The Warfarin plasma concentration had no significant change（ P〉0.05） in three month, six month ,one year after surgery. ② No significant changes were found between in -patients and out -patients. Conclusion The plasma concentration of Warfarin was a sensitive index in monitoring anticoagulation. The combination of Warfarin plasma concentration with INR and PT could improve the precision of anticoagulation and decrease complications.