肺栓塞患者华法林稳态血药浓度监测结果回顾分析

Retrospective analysis of blood concentration monitoring results of warfarin in patients with pulmonary embolism

目的 分析肺栓塞患者华法林稳态血药浓度监测结果。方法 收集2013年10月至2016年9月于上海交通大学医学院附属新华医院呼吸科病房住院的103例肺栓塞患者的临床资料。华法林血药浓度测定采用高效液相色谱（HPLC）法，分析其在不同年龄、性别患者中的差异。结果 103患者华法林稳态血药浓度平均值为（0.74±0.33）mg/L。华法林血药浓度随患者年龄的增加有升高趋势，但差异无统计学意义（P〉0.05）。女性患者的华法林稳态血药浓度明显高于男性患者，差异有统计学意义［（0.84±0.45）mg/L比（0.65±0.33）mg/L］（P〈0.05）。结论 肺栓塞患者服用华法林后，血药浓度个体差异较大。及时监测肺栓塞患者华法林血药浓度有助于及时调整用药剂量，促进华法林个体化给药方案的实施。

Objective To analyze the blood concentration of warfarin in patients with pulmonary embolism. Methods Clinical data of 103 cases of pulmonary embolism from Department of Respiratory Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed from October 2013 to September 2016. All patients were detected blood concentration of warfarin by high performance liquid chromatography; the results were analyzed among different age and gender groups. Results The average blood concentration of warfarin in 103 patients was （0.74±0.33）mg/L. There was an increasing trend of warfarin concentration with age, but the difference was not significant（P〉0.05）. The concentration of warfarin in female was higher than that in male[（0.84±0.45）mg/L vs （0.65±0.33）mg/L], the difference was statistically significant（P〈0.05）. Conclusion The blood-drug concentration shows individual differences in patients taking warfarin; blood concentration monitoring of warfarin is necessary.