华法林治疗急性下肢深静脉血栓形成患者凝血酶原-国际标准化比值国人适宜性有效值的初步探讨

目的 初步探讨华法林治疗急性期下肢深静脉血栓形成(DVT)患者适宜国人的凝血酶原-国际标准化比值(PT-INR).方法 选择具有华法林抗凝治疗适应证的DVT患者87例,随机分为A、B 2组,A组(47例)应用华法林,调整PT-INR在1.7～2.5,B组(40例)应用华法林,调整PT-INR在2.0～3.0,比较华法林治疗的有效性及出血并发症的发生率.结果 A组47例患者,46例肢体肿胀明显减退消失,1例无效,经彩超、GT及肿瘤标志物检查,考虑为盆腔肿瘤,有效率为98%;全部患者无明显出血症状.B组40例患者,38例肢体肿胀明显减退消失,2例症状好转不明显,其中Cockett综合征1例,另一例原因不明,有效率为95%;3例出现轻度牙龈及鼻黏膜出血,1例出现胃肠道内出血.2组无肺栓塞发生.结论 国人急性DVT治疗中PT-INR调整在1.7～2.5同样有效,且出血等并发症明显减少.

Abstract：

Objective To explore the suitable range of PT-INR for Chinese people with acute deep venous thrombosis (DVT) treated by warfarin anticoagulation therapy. Methods Eighty seven DVT patients with indications to warfarin anticoagulation therapy were enrolled into the study and divide into two groups randomly. Patients from group A (n=47) took warfarin to adjust the PT-INR to range 1.7-2. 5,and patients from group B (n =40) took warfarin to adjust the PT-INR to range 2. 0-3. 0. The therapeutic effectiveness and the incidence of bleeding complications were compared between two groups. Results Forty-six patients (46/47,98%) had limb swelling symptoms relief in group A with one exception,which was diagnosed as pelvic tumor by ultrasonography,CT and tumor markers examination later. No patient underwent bleeding in group A Thirty eight patients (38/40,93%) had limb swelling symptoms relief in group group B with two exceptions,of which one case had Cockett syndrome and the other one had unknown aetiology. The total effective rate of group B was 95% . As to the complications of this group,3 patients had slight gum and nasal mucous membrane bleeding, 1 patient developed gastrointestinal bleeding. No patients had pulmonary embolism in both groups. Conclusion For Chinese people,anticoagulation therapy of acute deep venous thrombosis to adjust the range of PT-INR to 1.7-2. 5, shows good effectiveness and significantly reduced bleeding complications.

The suitable range of PT-INR for Chinese people with acute deep venous thrombosis treated by warfarin anticoagulation therapy

Objective To explore the suitable range of PT-INR for Chinese people with acute deep venous thrombosis (DVT) treated by warfarin anticoagulation therapy. Methods Eighty seven DVT patients with indications to warfarin anticoagulation therapy were enrolled into the study and divide into two groups randomly. Patients from group A (n=47) took warfarin to adjust the PT-INR to range 1.7-2. 5,and patients from group B (n =40) took warfarin to adjust the PT-INR to range 2. 0-3. 0. The therapeutic effectiveness and the incidence of bleeding complications were compared between two groups. Results Forty-six patients (46/47,98%) had limb swelling symptoms relief in group A with one exception,which was diagnosed as pelvic tumor by ultrasonography,CT and tumor markers examination later. No patient underwent bleeding in group A Thirty eight patients (38/40,93%) had limb swelling symptoms relief in group group B with two exceptions,of which one case had Cockett syndrome and the other one had unknown aetiology. The total effective rate of group B was 95% . As to the complications of this group,3 patients had slight gum and nasal mucous membrane bleeding, 1 patient developed gastrointestinal bleeding. No patients had pulmonary embolism in both groups. Conclusion For Chinese people,anticoagulation therapy of acute deep venous thrombosis to adjust the range of PT-INR to 1.7-2. 5, shows good effectiveness and significantly reduced bleeding complications.