【摘要】 目的探讨不同剂量华法林在机械心脏瓣膜置换术后的抗凝指标情况。方法将116例成功接受机械心脏瓣膜置换术后仅用华法林抗凝者纳入研究,监测凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、血栓前蛋白(TpP)、D2聚体(D-Dimer)、国际标准化比值(INR),并记录不同剂量组患者的基线资料。结果体重>61kg、年龄>55岁、女性的华法林用量明显升高;华法林剂量>6mg/d时,凝血四项均值变化显著;华法林口服量<4.25mg/d,INR<1.5,TpP及D2水平明显升高;华法林用量在4.25~6mg/d,并发症较低。结论华法林用量与体重、年龄、性别有关;不同凝血指标对华法林剂量调整有各自的价值;华法林用量在3~6mg/d时较为安全。更多还原

【Abstract】 Objective To investigate the relationship between different dosage of warfarin-associated bleeding after mechanical prosthetic valve replacement and coagulation index.Methods A total of 116 patients with mechanical prosthetic valve replacement were enrolled in the study and given warfarin.PT,FIB,APTT,TT,TpP,D2 and INR of all the patients were monitored under different warfarin dosage.Results The patients with weight>61kg,age>55,female were given warfarin high dosage.The coagulation index changed significantly when warfarin dosage in 6mg/d.Warfarin dosage<4.25mg/d and INR<1.5 TpP,D2 levels were increased.Warfarin dosage between4.25mg/d and 6mg/d the incidence of complications was low.Conclusions Weight,age,gender are related to warfarin dose.Coagulation indexes have their own value to warfarin dosage.Warfarin dosage between 3~6mg/d is safer.更多还原