胺碘酮对心脏瓣膜术后华法林初始抗凝疗效的影响

Effect of Amiodarone on Initial Anticoagulation of Warfarin in Patients after Heart Valve Surgery

目的:探讨胺碘酮对心脏瓣膜术后华法林初始抗凝疗效的影响。方法:选取2013年5月～2014年8月在我院接受心脏瓣膜术患者为研究对象,以术后口服胺碘酮为研究组,未服用者为对照组,分别记录患者基本信息、手术名称、术后肝肾功能、甲状腺功能及患者住院期间抗凝治疗情况。结果:研究组28例(24.35%),对照组87例(75.65%)。研究组INR首次达标时间(5.19±2.51)d,较对照组(6.49±2.52)d明显缩短(P=0.04),且INR达标维持时间(5.24±2.42)d,亦较对照组(6.90±5.37)d明显缩短(P=0.02)。两组患者华法林剂量、INR达标情况及不良事件发生率未见明显不同(P>0.05)。结论:胺碘酮可缩短华法林初始抗凝达标时间,但未能提高抗凝总体达标率。

Objective:To investigate the effect of amiodarone on the initial anticoagulant effects of warfarin after heart valve surgery.Methods:The patients who underwent heart valve surgery in our hospital in May 2013 to August 2014 were selected to record the basic information and the anticoagulant therapy during hospitalization.Results:There were 28 cases in the study group(24.35%)combining amiodarone treatment and 87 cases in the control group(75.65%).The INR target was reached the first time at(5.19±2.51)days in the study group,which was significantly shorter than that at(6.49±2.52)days(P=0.04)in the control group;and the INR target was maintained for(5.24±2.42)days in the study group,which was also significantly shorter than that for(6.90±5.37)days(P=0.02)in the control group.There was no significant difference on warfarin dosage,INR compliance or incidence of adverse events between the two groups(P>0.05).Conclusion:Amiodarone can shorten the initial anticoagulation time of warfarin but cannot improve the overall rate of anticoagulation.