【摘要】 目的探讨适合我国东北人群特点的人工机械瓣膜置换术后抗凝治疗强度标准。方法对2005年1月至2013年6月在吉林大学第二医院心血管外科完成的856例[男406例、女450例,年龄(45.2±13.3)岁]置换人工机械瓣膜的东北人群患者,采用了低强度的抗凝标准[国际标准化比值(INR)1.5~2.2,主动脉瓣置换术(AVR):1.5~1.8;二尖瓣置换术(MVR):1.8~2.2],通过术后随访,分析该抗凝标准下人工机械瓣膜术后与抗凝相关的并发症发生率。结果本组患者随访时间1~78(18.3±12.2)个月,总随访率为75.4%,发生血栓栓塞12例(1.86%)。发生与抗凝有关的出血10例(1.55%)。随访口服华法林剂量(3.4±0.8)mg/d,随访INR 1.94±0.54。结论在我国东北患者中采用低强度抗凝治疗(INR 1.5~2.2:AVR 1.5~1.8,MVR 1.8~2.2)标准,可以获得满意的预防血栓栓塞,减少与抗凝有关的出血等并发症的效果。更多还原

【Abstract】 Objective To explore optimal intensity of oral anticoagulation for patients with prosthetic heart valves in Northeast China. Methods A total of 856 patients in Northeast China who underwent prosthetic heart valve replacement in the Department of Cardiovascular Surgery,Second Hospital of Jilin University from January 2005 to June 2013 were enrolled in this study. There were 406 male and 450 female patients with their age of 45.2±13.3 years. All the patients received low-intensity oral anticoagulation [international normalized ratio(INR) 1.5-2.2,aortic valve replacement(AVR): 1.5-1.8,mitral valve replacement(MVR):1.8-2.2]. Patients were followed up after discharge,and the incidence of anticoagulation-related complications was summarized. Results These patients were followed up for 1-78(18.3±12.2) months, and the follow-up rate was 75.4%. Twelve patients(1.86%) had thromboembolic complications and 10 patients(1.55%)had hemorrhagic complications. Average warfarin dosage was 3.4±0.8 mg/day,and average INR was 1.94±0.54 during follow-up. Conclusion For patients with prosthetic heart valves in Northeast China,low-intensity anticoagulation can produce satisfactory clinical outcomes to reduce the incidence of anticoagulation-related thromboembolic or hemorrhagic complications.更多还原