發(fā)布時(shí)間：2018-07-04 08:15

  本文選題：華法林 + 對(duì)映體　； 參考：《中國(guó)藥房》2015年30期

【摘要】：目的:探討心臟瓣膜置換術(shù)后國(guó)際標(biāo)準(zhǔn)化比值(INR)與華法林對(duì)映體血漿濃度及給藥劑量的相關(guān)性。方法:監(jiān)測(cè)176例心臟機(jī)械瓣膜置換術(shù)后接受華法林抗凝治療的患者各時(shí)間點(diǎn)給藥劑量、R-華法林和S-華法林血漿濃度及INR,觀察INR與華法林對(duì)映體血漿濃度及單位體質(zhì)量給藥劑量的相關(guān)性。結(jié)果:所有患者給藥劑量在24~288 h時(shí)均顯著高于0 h時(shí),差異均有統(tǒng)計(jì)學(xué)意義(P0.001);96 h后患者給藥劑量在一定范圍內(nèi)上下波動(dòng),較96 h時(shí)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。R-華法林、S-華法林平均血漿濃度變化趨勢(shì)一致,108 h后對(duì)映體血漿濃度在一定范圍內(nèi)上下波動(dòng),差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。INR在12 h時(shí)較0 h時(shí)比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),在36 h時(shí)顯著上升,之后一直上升,至108 h后在一定范圍內(nèi)上下波動(dòng),較108 h時(shí)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。INR與華法林單位體質(zhì)量給藥劑量60 h時(shí)相關(guān)系數(shù)36 h時(shí)12 h時(shí),且具有相關(guān)性(P0.001);華法林血漿濃度與給藥劑量在12、36、60 h時(shí)均有一定相關(guān)性(P0.001)。結(jié)論:華法林對(duì)映體血漿濃度與單位體質(zhì)量給藥劑量的相關(guān)性強(qiáng)于INR與單位體質(zhì)量劑量的相關(guān)性,在同其他凝血指標(biāo)相結(jié)合時(shí),可能有助于華法林的劑量管理。
[Abstract]:Objective: To investigate the correlation between the international standardized ratio (INR) and the dose of Hua Falin enantiomers after heart valve replacement. Methods: to monitor the dose, plasma concentration of R- Hua Falin and S- Hua Falin and INR, and to observe INR and Hua Falin in 176 cases of cardiac valve replacement after cardiac valve replacement. The correlation between the concentration of enantiomer plasma and the mass of the unit body. Results: all patients were significantly higher than 0 h at 24~288 h, the difference was statistically significant (P0.001). After 96 h, the dosage of the patients fluctuated up and down in a certain range, and the difference was not statistically significant (P0.05).R- warfarin, S- warfarin average. The change trend of plasma concentration was consistent, after 108 h, the plasma concentration of enantiomers fluctuated up and down in a certain range, and the difference was not statistically significant (P0.05).INR at 12 h compared with 0 h (P0.05), it increased significantly at 36 h, and then rose, after 108 h, fluctuated up and down in a certain range, and the difference was not statistically significant compared to 108 H. The correlation coefficient between P0.05.INR and Hua Falin unit body mass was 60 h when the correlation coefficient was 36 h and 12 h, and had correlation (P0.001). The plasma concentration of Hua Falin and the dosage of the agent had a certain correlation (P0.001) at 12,36,60 H. Conclusion: the correlation between the concentration of the enantiomer of the enantiomers and the mass of the unit body is stronger than the INR and unit. The correlation between body mass and dose may be helpful to warfarin dose management when combined with other coagulation parameters.
【作者單位】： 南京醫(yī)科大學(xué)附屬南京醫(yī)院藥劑科;南京醫(yī)科大學(xué)附屬南京醫(yī)院心胸外科;南京市藥品集中采購(gòu)?fù)泄苤行?
【基金】：南京市科技發(fā)展計(jì)劃項(xiàng)目(No.201402050)
【分類號(hào)】：R969

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本文編號(hào)：2095423