影响房颤患者华法林抗凝控制质量的因素分析

目的：了解房颤（atrial fibrillation，AF）患者华法林应用情况，探索影响华法林抗凝控制质量的因素。方法：收集2015年某院门诊应用华法林房颤患者信息，计算每位患者抗凝治疗范围内时间百分比[the percentage time in therapeutic International Normalised Ratio（INR）range，TTR]评价抗凝控制质量，应用χ²检验、t检验及logistic多元回归分析，探讨影响TTR的相关因素。结果：71例患者平均TTR为68.97%±12.12%，超过一半患者（53.52%）的TTR≥70%，单变量分析发现TTR≥70%患者与TTR<70%患者在年龄、职业、文化程度、出血风险（HAS-BLED）、INR检测次数、并发症数目方面均有显著差异（P<0.05），logistic多元回归分析结果显示职业、INR检测次数、并发症数目与抗凝质量控制显著相关（P<0.05）。结论：职业、INR检测次数、并发症数目是影响房颤患者抗凝控制质量的相关因素。临床药师应做好华法林用药患者的随访工作，提高患者抗凝控制质量。

Analysis of influencing factors associated with anticoagulation quality of warfarin in atrial fibrillation patients

OBJECTIVE To investigate the application of warfarin in outpatients with atrial fibrillation (AF),and explore factors affecting anticoagulation.METHODS Data of AF outpatients taking warfarin in our hospital in 2015 were collected,and the individual percentage time in therapeutic International Normalized Ratio (INR) range (TTR) was calculated to evaluate anticoagulation.The influencing factors on TTR were finally analyzed using Chi-square test,t test and multivariate logistic regression analysis.RESULTS Average TTR of 71 patients was 68.97%±12.12%,and 53.52% patients spent 70% or more time in therapeutic range (TTR≥70%).Univariate analysis showed significant difference between patients with TTR≥70% and patients with TTR<70% in age,career,educational level,HAS-BLED,INR monitoring frequency and the number of complications (P<0.05),multivariate logistic regression analysis showed that career,INR monitoring frequency and the number of complications were significantly associated with anticoagulation (P<0.05).CONCLUSION Career,INR monitoring frequency and the number of complications can affect anticoagulation in AF patients taking warfarin.It is necessary for clinical pharmacists to follow up patients taking warfarin to improve anticoagulation.