下肢深静脉血栓患者口服华法林初始剂量探讨

目的：探讨不同年龄的下肢深静脉血栓（ deep venous thrombosis ，DVT）患者口服华法林的最佳初始剂量。方法我科2012年1月至2013年10月收治112例急性下肢深静脉血栓患者，根据患者年龄分为甲、乙、丙三组，并给予不同的初始剂量，甲组27例（＜51岁，初始剂量3.75 mg），乙组52例（51～70岁，初始剂量2.5 mg），丙组33例（＞70岁，初始剂量1.25 mg）。通过监测国际化标准比值（ INR）调整华法林用量，监测三组患者INR达到2.0～3.0时的时间及华法林维持剂量。结果 INR达到2.0～3.0时，甲组用时（7.2±1.2）d，华法林剂量为（4.23±0.82）mg；乙组用时（9.3±1.5）d，华法林剂量为（4.05±0.64）mg；丙组用时（9.7±0.7）d，华法林剂量为（3.32±0.45）mg。结论对于不同年龄的急性DVT患者，可选择不同的华法林初始剂量，使患者更快、更安全的达到维持剂量。

An investigation of initial doses of oral warfarin in treatment of patients with lower extremity deep vein thrombosis

Objective To explore the optimal initial doses of oral warfarin in treatment of patients with deep venous thrombosis （ DVT） in different ages .Methods One hundred and twelve patients with acute DVT were received and cured in our department from January 2012 to October 2013.The patients were divided into A ,B and C groups according to the patient＇s age.The three groups were given different initial dose.The group A （n =27 with age 〈51 years old） was give an initial dose of 3.75 mg.The group B （n =52 with age 51-70 years old） was given an initial dose of 2.5 mg.The group C （n =33 with age〉70 years old） was given an initial dose of 1.25 mg.The warfarin doses were adjusted through monitoring INR .The time of reaching INR 2.0-3.0 and warfarin maintenance do-ses were monitored.Results The time of reaching INR 2.0-3.0 was（7.2 ±1.2）d in the group A,（9.3 ±1.5）d in the group B and （9.7 ±0.7）d in the group C,respectively.The maintenance warfarin doses were （4.23 ±0.82）mg in the group A,（4.05 ±0.64）mg in the group B and （3.32 ±0.45）mg in the group C,respectively.Conclusion For acute DVT patients,an initial dose of warfarin should be selected according to ages of patients so that patients could reach the maintenance doses faster and safer .