【摘要】：目的了解華法林在我院腎病患者中的應用情況。方法收集北京大學第一醫(yī)院2014-07-01—2014-12-31在腎內科病房住院并服用華法林的患者的臨床資料,對患者服用華法林的適應證、用藥劑量、國際標準化比值(INR)目標范圍和住院期間INR水平,以及相關藥物不良反應等進行統(tǒng)計分析。結果共納入150名服用華法林的患者。患者應用華法林的適應證共有6項,主要用于腎病綜合征患者血漿白蛋白明顯降低時的預防性抗凝治療(130例,占86.67%)。127例患者為首次使用華法林,其初始劑量有3 mg(65例)、1.5 mg(52例)或2.25 mg(10例),維持劑量為(2.46±1.26)mg。患者的INR目標范圍存在較大差異,其中75例(50.00%)患者出院時INR1.5,103例(68.67%)出院時INR2.0。發(fā)生可能與華法林相關的出血事件6例,發(fā)生率為4.00%。結論腎病患者服用華法林的劑量較低,INR值較低,是否需要進行藥學干預,還需要進一步的循證學證據(jù)和臨床試驗結果支持。
[Abstract]:Objective to investigate the application of warfarin in patients with kidney disease in our hospital. Methods the clinical data of patients hospitalized in the Department of Nephrology and taking warfarin in the first Hospital of Peking University were collected. The indications, dosage, target range of international standardized ratio (INR) and INR level during hospitalization, as well as related adverse drug reactions, were statistically analyzed. Results A total of 150 patients taking warfarin were included. There were 6 indications of warfarin, which were mainly used in prophylactic anticoagulant therapy (130 cases, 86.67%) when plasma albumin was significantly decreased in patients with nephrotic syndrome. 127 patients were treated with warfarin for the first time, the initial dose was 3 mg (65 cases), 1.5 mg (52 cases) or 2.25 mg (10 cases), and the maintenance dose was (2.46 鹵1.26) mg.. There were significant differences in the target range of INR in 75 patients (50.00%). INR 1.5103 cases (68.67%) were discharged from hospital with INR 1.5103 cases (68.67%). Bleeding events related to warfarin occurred in 6 cases (4.00%). Conclusion the dose of warfarin is low and the INR value is low in patients with kidney disease. Further evidence-based evidence and clinical trial results are needed to support the need for pharmaceutical intervention.
【作者單位】： 北京大學第一醫(yī)院藥劑科;北京大學藥學院藥事管理與臨床藥學系;
【基金】：國家自然科學基金資助項目(81273592,81202592,81573504)
【分類號】：R692

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