新型冠状病毒疫苗对心脏机械瓣膜置换术后患者INR值影响的横断面调查

The effect of COVID-19 vaccine on international normalized ratio value of patients after cardiac mechanical valve replacement:A cross-sectional investigation

目的探索心脏机械瓣膜置换术后患者新型冠状病毒(新冠)疫苗的接种率,同时评估其对国际标准化比值(international normalized ratio,INR)的影响。方法调查2021年5—10月在四川大学华西医院心脏大血管外科门诊随访的心脏机械瓣膜置换术后132例患者新冠疫苗的接种率,其中男51例、女81例,年龄26~72(53.01±9.51)岁。结果全组患者新冠疫苗接种率为53.8%。61例未接种疫苗患者中,患者担心疫苗对心脏有副作用是影响接种的主要原因。接种后首次复查INR平均值高于接种前最后一次INR值,差值为0.40±0.72,差异有统计学意义(P<0.001)。结论心脏机械瓣膜置换术后患者新冠疫苗接种率偏低。同时,新冠疫苗可能会提高INR值,接种后建议患者增加复查频率,并相应调整华法林用量。

Objective To investigate the vaccination rate of Coronavirus Disease 2019(COVID-19)vaccine in patients undergoing cardiac mechanical valve replacement and to evaluate its effect on international normalized ratio(INR)value.Methods We investigated 132 patients who had received cardiac mechanical valve replacement and followed up in the Department of Cardiovascular Surgery,West China Hospital of Sichuan University from May to October 2021.There were 51 males and 81 females aged 26-72(53.01±9.51)years.Results The vaccination coverage rate was 53.8%.Among the 61 unvaccinated patients,concerns about heart side-effects were the main reason.The average INR of the first review after vaccination was higher than that of the last review before vaccination,with a difference of 0.40±0.72(P<0.001).Conclusion The vaccination rate of patients after cardiac mechanical valve replacement is low.At the same time,COVID-19 vaccine may increase INR value,and it is suggested that patients should increase the frequency of review and adjust warfarin dosage after vaccination.