华法林治疗心房颤动中INR异常增高的影响因素

Factors Affecting Abnormal Increase of INR in Warfarin Treatment of Atrial Fibrillation

目的探讨房颤患者华法林初始治疗过程中INR异常增高的影响因素。方法选取医院2017年4月-2019年4月住院且口服华法林抗凝治疗的心房颤动患者共75例,详细记录每例患者基本情况,合并疾病,合并用药等。主要观察一周内有无INR异常增高(INR> 3)情况,根据有无INR异常增高,分为异常增高组和无异常增高组。通过logistic回归方法评价各个可能的对INR异常增高的影响因素。结果对各个可能的影响INR的因素作单变量分析仅发现年龄,体重,肝功能异常在两组间有显著差异。进一步通过多变量统计分析发现年龄,体重是独立的影响因素。结论年龄,体重是INR异常增高的独立影响因素。对于高龄和低体重的患者,使用华法林时应该加强监测,及时调整剂量,以确保疗效和安全。

Objective To explore the influencing factors of abnormally high INR during the initial treatment of warfarin in patients with AF. Methods A total of 75 patients with atrial fibrillation who were hospitalized in our hospital from April 2017 to April 2019 and were treated with oral warfarin anticoagulation were selected. The basic information of each patient, combined disease, combined medication, etc. were recorded in detail. The main observation was whether there was an abnormal increase in INR within one week(INR > 3). According to whether there was an abnormal increase in INR, it was divided into an abnormal increase group and an abnormal increase group. Logistic regression method was used to evaluate each possible influence on the abnormal increase of INR. Results Univariate analysis of each possible influencing factor of INR only found that there were significant differences between the two groups in age, weight and liver function abnormality. Through multivariate statistical analysis, we found that age and weight were independent factors. Conclusion Age and body weight are independent factors of abnormal increase in INR. For elderly and low-weight patients, monitoring should be strengthened when warfarin is used, and the dose should be adjusted in time to ensure efficacy and safety.