国际规格化比值(INR)的抗凝监测在缺血性脑血管病中的应用

INR monitoring of oral anticoagulant therapy in patients with ischemic cerebrovascular disease

目的：研究适合我国缺血性脑血管病抗凝监测的国际规格化比值（ＩｎｔｅｒｎａｔｉｏｎａｌＮｏｒｍａｌｉｚｅｄＲａｔｉｏ简称ＩＮＲ）范围。方法：对１４例抗凝治疗患者，同时监测凝血酶原时间（ＰＴ）及其活动度（ＡＴ）、ＩＮＲ，并将结果进行对照分析。结果：所有患者均达到了预期的治疗效果，抗凝期间出血发生率为１４．３％，无１例发生严重或致命性出血。３５９次检测中ＡＴ值位于２５％～４４％者占７５．５％，此时相应的ＩＮＲ值为１．８８～３．２０。结论：采用ＩＮＲ监测抗凝治疗时建议治疗范围控制于２．０～３．０。

Purpose:To study the proper range of international normalized Ratio (INR) for oral anticoagulant therapy in patients with ischemic cerebrovascular disease.Method:Fourteen patients with ischemic cerebrovascular disease who received anticoagulant therapy,prothrombin time (PT),activity of prothrombin (AT) and INR were monitored and compared.Results:All patients had optimal outcome.The percentage of bleeding during oral anticoagulant was 14.3%.None of these patients had serious or fatal bleeding.Among the total 359 AT tests,271(75.5%) AT tests ranged between 25% to 44%,the corresponding INR were between 1.88 to 3.20.Conclusion:This study suggested that INR between 2.0 to 3.0 might be a proper range for anticoagulant therapy in Chinese patients with ischemic cerebrovascular diseases.