心脏瓣膜置换术后华法林药物基因导向个体化抗凝治疗的临床意义

发布时间：2018-03-18 17:35

本文选题：心脏瓣膜置换　切入点：华法林　出处：《首都医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:比较华法林基因指导剂量和标准剂量对心脏瓣膜置换术后患者的初始抗凝治疗效果。方法:将入选的60例需要行心脏瓣膜机械瓣置换术的患者,分为基因组和对照组,每组各30例。基因组患者接受基因指导剂量华法林3天,对照组患者接受3mg华法林3天,后两组患者根据INR值调整华法林剂量。主要终点指标为INR值在1.8-2.5的时间在2个月内的时间百分数。结果:共有56例患者完成随访,27例基因组,29例对照组。基因组INR达标时间百分数为76.72%,而对照组则为59.23%(95%CI,8.6-26.4;P0.001)。基因组达标时间中位数为21天,对照组达标时间中位数为27天。抗凝不足天数百分率、过度抗凝天数百分率、出血和栓塞事件无显著性差异。结论:心脏瓣膜置换术后患者的初始抗凝治疗时,华法林基因指导剂量优于标准剂量。
[Abstract]:Objective: to compare the effect of warfarin gene guiding dose and standard dose on the initial anticoagulant therapy of patients undergoing cardiac valve replacement. Methods: 60 patients who needed valvular mechanical valve replacement were divided into genome and control group. Genomics patients received gene guidance dose warfarin for 3 days, and control group patients received 3 mg warfarin for 3 days. The final two groups of patients adjusted warfarin dose according to the INR value. The main endpoint index was the percentage of the time of INR between 1.8-2.5 and within 2 months. Results: a total of 56 patients were followed up in 27 patients with genomes and 29 in the control group. The percentage of INR reaching the standard was 76.72%, while that of the control group was 59.23%, and that of the control group was 8.6-26.4% (P 0.001). The median time of reaching the standard of the genome was 21 days. There was no significant difference in the percentage of days of anticoagulant deficiency, the percentage of excessive anticoagulant days, bleeding and embolism events in the control group. Conclusion: the initial anticoagulant therapy for patients after cardiac valve replacement was not significant. The guided dose of warfarin gene was superior to the standard dose.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2

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