华法林在肾病住院患者中的用药分析

发布时间：2019-07-04 12:12

【摘要】：目的了解华法林在我院肾病患者中的应用情况。方法收集北京大学第一医院2014-07-01—2014-12-31在肾内科病房住院并服用华法林的患者的临床资料,对患者服用华法林的适应证、用药剂量、国际标准化比值(INR)目标范围和住院期间INR水平,以及相关药物不良反应等进行统计分析。结果共纳入150名服用华法林的患者。患者应用华法林的适应证共有6项,主要用于肾病综合征患者血浆白蛋白明显降低时的预防性抗凝治疗(130例,占86.67%)。127例患者为首次使用华法林,其初始剂量有3 mg(65例)、1.5 mg(52例)或2.25 mg(10例),维持剂量为(2.46±1.26)mg。患者的INR目标范围存在较大差异,其中75例(50.00%)患者出院时INR1.5,103例(68.67%)出院时INR2.0。发生可能与华法林相关的出血事件6例,发生率为4.00%。结论肾病患者服用华法林的剂量较低,INR值较低,是否需要进行药学干预,还需要进一步的循证学证据和临床试验结果支持。
[Abstract]:Objective to investigate the application of warfarin in patients with kidney disease in our hospital. Methods the clinical data of patients hospitalized in the Department of Nephrology and taking warfarin in the first Hospital of Peking University were collected. The indications, dosage, target range of international standardized ratio (INR) and INR level during hospitalization, as well as related adverse drug reactions, were statistically analyzed. Results A total of 150 patients taking warfarin were included. There were 6 indications of warfarin, which were mainly used in prophylactic anticoagulant therapy (130 cases, 86.67%) when plasma albumin was significantly decreased in patients with nephrotic syndrome. 127 patients were treated with warfarin for the first time, the initial dose was 3 mg (65 cases), 1.5 mg (52 cases) or 2.25 mg (10 cases), and the maintenance dose was (2.46 卤1.26) mg.. There were significant differences in the target range of INR in 75 patients (50.00%). INR 1.5103 cases (68.67%) were discharged from hospital with INR 1.5103 cases (68.67%). Bleeding events related to warfarin occurred in 6 cases (4.00%). Conclusion the dose of warfarin is low and the INR value is low in patients with kidney disease. Further evidence-based evidence and clinical trial results are needed to support the need for pharmaceutical intervention.
【作者单位】： 北京大学第一医院药剂科;北京大学药学院药事管理与临床药学系;
【基金】：国家自然科学基金资助项目(81273592,81202592,81573504)
【分类号】：R692

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