【摘要】：目的回顧性分析比較臨床藥師藥學(xué)干預(yù)前后心房顫動(dòng)患者的抗凝現(xiàn)狀,為提高抗凝治療的安全性、合理性提供參考。方法將2014、2015年度該院住院心房顫動(dòng)患者分別作為對(duì)照組(718例)與觀察組(825例),其中觀察組給予藥學(xué)干預(yù)。對(duì)兩組患者的抗凝治療率、抗凝藥物相關(guān)出血反應(yīng)、凝血酶原時(shí)間(PT)經(jīng)校正后的國際標(biāo)準(zhǔn)化比值(INR)等情況進(jìn)行回顧調(diào)查與比較。同時(shí)對(duì)高齡(≥75歲)、合并慢性疾病、卒中風(fēng)險(xiǎn)評(píng)分(CHA2DS2-VASc)及出血風(fēng)險(xiǎn)評(píng)分(HAS-BLED)等因素進(jìn)行回歸分析。結(jié)果干預(yù)后觀察組抗凝治療率(19.8%)明顯高于對(duì)照組(15.0%),差異有統(tǒng)計(jì)學(xué)意義(P0.05),且抗凝藥物相關(guān)出血不良反應(yīng)發(fā)生率降至2.76%。干預(yù)后觀察組INR達(dá)標(biāo)率(22.1%)低于對(duì)照組(45.4%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素logistic回歸分析顯示,對(duì)照組抗凝治療影響因素為高齡、CHA2DS2-VASc評(píng)分及HAS-BLED評(píng)分(R_1=-0.287,R_2=0.095,R_3=-0.030);觀察組抗凝治療影響因素為高齡、有糖尿病史、CHA2DS2-VASc評(píng)分(R_1′=-0.279,R_2′=-0.052,R_3′=0.009)。結(jié)論藥學(xué)干預(yù)提高了該院心房顫動(dòng)抗凝治療率,但總抗凝治療率仍低于國內(nèi)平均水平,臨床藥師需進(jìn)一步加強(qiáng)用藥安全性、合理性、依從性等方面管理。
[Abstract]:Objective to analyze and compare the present situation of anticoagulation in patients with atrial fibrillation before and after pharmaceutical intervention by clinical pharmacists, so as to provide reference for improving the safety and rationality of anticoagulation therapy. Methods the patients with atrial fibrillation in 2014 and 2015 were selected as control group (718 cases) and observation group (825 cases), in which pharmaceutical intervention was given to the observation group. The anticoagulant treatment rate, anticoagulation drug-related bleeding response, and the corrected international standardized ratio (INR) of prothrombin time (PT) were retrospectively investigated and compared between the two groups. At the same time, the age (鈮，

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