抗凝治疗的患者门诊INR监测结果分析

摘要:目的　了解服用华法林的患者门诊INR监测频率及INR达到理想范围的情况，为临床医生调整药物剂量及随访管理提供依据。方法　从邯郸市第一医院门诊化验系统导出2013年1月1日至12月31日所有服用华法林并进行INR（国际标准化测量值）检查的患者，数据信息包括:病例号、姓名、性别、年龄、所患疾病、INR测量值。结果　1年内，共获得INR监测记录931条。包括患者411例，平均年龄（57.3±13.7）岁，男性占46.2%，女性占53.8%。198例患者（48.2%）测量1次INR，仅17.3%的患者测量4次以上INR值，心脏瓣膜手术患者拥有4次以上测量结果的比例最高（27.3%）。以最后1次INR测量值作为标准，INR值在2.0～3.0范围的患者达到42.8%，213例测量2次以上INR的患者中，35.2%的患者每月测量1次INR值，其中44.6%的患者INR测量值中半数以上在达标范围（2.0～3.0）。931人次INR测量结果，INR在2.0～3.0者占38.7%。心脏瓣膜手术患者INR达标水平较高。结论　抗凝治疗的患者每月测量INR的比例低，门诊INR检查达标率达到40.0%，瓣膜手术患者INR达标率较高。

Analysis on international normalized ratio monitoring and control in outpatients with warfarin treatment

Abstract: Objective The aim of this study was to analyze the monitoring adherence of INR (international normalized ratio) and INR control in patients with warfarin treatment, in order to give doctors some advice on INR monitoring and adjustment of drug dosage. Methods Nine hundred and thirty-one records of INR were collected from the electronic record system of the first hospital in Handan city from January 1st 2013 to December 31st 2013. All the patients were taking warfarin. The information including name, gender, age, history of disease and INR value was contained. Results A total of 931 records were related to 411 patients. The mean age of the 411 subjects (190 men and 221 women) were 57.3 (SD 13.7). One hundred and ninety-eight patients (48.2%) measured INR only one time, and 17.3% measured four times during the last year. This percentage was 27.3% in patients with cardiac valvular surgery. According to the latest value of INR, 42.8% of patients reached the ideal value from 2.0 to 3.0. Two hundred and thirteen patients measured INR three or over three times, among them 35.2% measured INR once a month and the percentage of half of INR value from 2.0 to 3.0 was 44.6%. Among 931 records, 38.7% reached the ideal value, and the percentage was higher in patients with cardiac valvular surgery. Conclusion The percentage of patients with warfarin treatment measured INR once a month was low, and about 40% of INR value reached the optimal range. It was higher in patients with cardiac valvular surgery.