不同年龄对房颤患者口服华法林后INR达标剂量的影响

Different age of oral warfarin in patients with atrial fibrillation after INR standard dose effect

目的探讨年龄对房颤患者口服华法林后国际标准化比值(INR)达标剂量的影响,为房颤患者华法林合理剂量的使用提供临床参考。方法以2015年5月~2017年5月本院门诊及住院的132例房颤患者为研究对象,全部患者均口服华法林进行治疗,依据年龄将入选病例分为低龄组(年龄<40岁,39例)、中龄组(年龄40~60岁,45例)、高龄组(年龄>60岁,48例),对比观察3组INR达标值以及达到目标值时的华法林服用剂量。结果 3组INR初始达标值与稳定达标值差异无统计学意义,3组INR初始达标和稳定达标时华法林剂量有统计学意义(P<0.05)。结论不同年龄患者对华法林的耐受和敏感性存在差异,老年房颤患者口服华法林INR初始剂量和维持剂量低于中青年患者,临床用药建议初期采用小剂量,同时严格控制INR在目标范围,以保证疗效及合理性,进一步提高患者用药安全。

Objective To study the age of oral warfarin in patients with atrial fibrillation after international standardization ratio（INR） the influence of the standard dose, for the use of warfarin in patients with atrial fibrillation and reasonable dosage for clinical reference. Methods In May2015-May 2017 of our hospital outpatient and in 132 patients with atrial fibrillation as the research object, all the patients were oral warfarin treatment, according to the selected cases can be divided into younger age groups（age40 years and 39 cases）, middle age group（40 to 60 years old, 45 cases）, aged group（60 years old, 48 cases）, comparative observation of 3 groups reached their values and achieve the target INR warfarin doses.Results There was no statistical difference between the initial and stable values of INR in group 3, and there was a statistical difference（P〈0.05）between the three groups of INR initial and stable standard. Conclusion Different age patients with warfarin differences, tolerance and sensitivity in elderly patients with atrial fibrillation oral warfarin INR initial dose and maintenance dose is lower than the young and middle-aged patients with clinical medicine suggested that the early with small doses, at the same time, strictly control the INR in target range, to ensure the effectiveness and rationality, further improve the patients medication safety.