心脏瓣膜置换术后国际标准化比值与华法林对映体血浆浓度及给药剂量的相关性研究

发布时间：2018-07-04 08:15

本文选题：华法林 + 对映体　；参考：《中国药房》2015年30期

【摘要】：目的:探讨心脏瓣膜置换术后国际标准化比值(INR)与华法林对映体血浆浓度及给药剂量的相关性。方法:监测176例心脏机械瓣膜置换术后接受华法林抗凝治疗的患者各时间点给药剂量、R-华法林和S-华法林血浆浓度及INR,观察INR与华法林对映体血浆浓度及单位体质量给药剂量的相关性。结果:所有患者给药剂量在24~288 h时均显著高于0 h时,差异均有统计学意义(P0.001);96 h后患者给药剂量在一定范围内上下波动,较96 h时差异均无统计学意义(P0.05)。R-华法林、S-华法林平均血浆浓度变化趋势一致,108 h后对映体血浆浓度在一定范围内上下波动,差异均无统计学意义(P0.05)。INR在12 h时较0 h时比较差异无统计学意义(P0.05),在36 h时显著上升,之后一直上升,至108 h后在一定范围内上下波动,较108 h时差异均无统计学意义(P0.05)。INR与华法林单位体质量给药剂量60 h时相关系数36 h时12 h时,且具有相关性(P0.001);华法林血浆浓度与给药剂量在12、36、60 h时均有一定相关性(P0.001)。结论:华法林对映体血浆浓度与单位体质量给药剂量的相关性强于INR与单位体质量剂量的相关性,在同其他凝血指标相结合时,可能有助于华法林的剂量管理。
[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.
【作者单位】：南京医科大学附属南京医院药剂科;南京医科大学附属南京医院心胸外科;南京市药品集中采购托管中心;
【基金】：南京市科技发展计划项目(No.201402050)
【分类号】：R969

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