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许建屏, 石应康, 董力等. 中国人心脏瓣膜置换术后低强度抗凝治疗3 000例随访1年报告[J]. koko体育app 学报(医学版), 2016, 47(1): 90-92.
引用本文: 许建屏, 石应康, 董力等. 国内 人心瓣膜引流酱紫低程度抗凝中药治疗3 000例随访在一年上报[J]. 江苏专科大学学报(医学专业版), 2016, 47(1): 90-92.
XU Jian-ping, SHI Ying-kang, DONG Li. et al. Low Intensity Anticoagulation Therapy for Chinese Population with Heart Valve Replacement——3 000 Cases Follow-up[J]. Journal of Sichuan University (Medical Sciences), 2016, 47(1): 90-92.
Citation: XU Jian-ping, SHI Ying-kang, DONG Li. et al. Low Intensity Anticoagulation Therapy for Chinese Population with Heart Valve Replacement——3 000 Cases Follow-up[J]. Journal of Sichuan University (Medical Sciences), 2016, 47(1): 90-92.

中国人心脏瓣膜置换术后低强度抗凝治疗3 000例随访1年报告

Low Intensity Anticoagulation Therapy for Chinese Population with Heart Valve Replacement——3 000 Cases Follow-up

  • 摘要: 目的 研究中国人心脏瓣膜置换术后早期低强度抗凝的疗效。方法 对2011年1月至2012年3月间,北京阜外医院成人心脏中心和koko体育app 华西医院心外科有完整住院资料的3 000例瓣膜置换术后患者随访1年,分析抗凝治疗强度、方法及并发症等指标。结果 共2 657例获随访,随访率88.57% ,随访总量1 726.1患者/年(Pty)。 华法林剂量0.625~12.0(2.68±6.45) mg/d;阜外医院国际标准比值(INR)实测均值为2.01±1.10, 华西医院1.86±0.69,两院间实际抗凝强度(INR均值1.8~2.0) 相似,差异无统计学意义(P=0.28)。抗凝总并发症发生及死亡率分别为5.79% Pty与0.12% Pty;其中出血发生及死亡率分别为3.59% Pty与0.12% Pty;严重性出血发生及死亡率分别为0.29% Pty与0.12% Pty;栓塞发生及死亡率分别为2.03% Pty与0.00% Pty,血栓形成发生及死亡率分别为0.29% Pty与0.00% Pty。 结论 中国人心脏瓣膜置换术后采用低强度抗凝治疗(INR 1.5~2.5),取得了栓塞与血栓并发症发生率无明显增加,出血并发症发生及死亡率明显降低的疗效。 国人抗凝治疗强度并无明显地域差别。  
    Abstract: Objective To investigate the effect of low-intensity anticoagulation therapy for Chinese population with heart valve replacement. Methods From January 2011 to March 2012, 3 000 patients with heart valve replacement in Fuwai Hospital and West China Hospital were followed-up for 1 year, the method and intensity of postoperative anticoagulation, as well as the complications were studied and analyzed. Results The rate of follow-up was 88.57%, and the cumulative follow-up was 1 726.1 patient-years (Pty). The mean oral warfarin dosage was (2.68±6.45) mg/d, and the mean INR values of the patients treated in Fuwai Hospital and West China Hospital were 2.01±1.10 and 1.86±0.69 respectively (total 54 379 samples).The total rates of anticoagulation complication and mortality were 5.79% Pty and 0.12% Pty respectively, among which the morbidity and mortality of hemorrhage were 3.59% Pty and 0.12% Pty respectively, while the morbidity and mortality of thromboembolism were 2.03% Pty and 0.00% Pty respectively. There are no significant differences of actual anticoagulation intensity (P=0.28)and the complication rates between the two hospitals .Conclusion The optimal intensity scope (INR) of 1.5-2.5 (mean 1.8-2.0) is safe and efficient for Chinese patients with prosthetic heart valves, and no significant regional difference in the intensity of anticoagulation therapy required.  
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