老年患者服用低剂量华法林理想INR值的判断研究

摘要

目的 评价不同INR目标值在老年患者口服华法林预防血栓事件的临床疗效.方法 回顾性分析2010年1月～2016年1月在我院就诊的需口服华法林抗凝的老年患者237例,分为窄INR组108例(INR目标值2.0-2.5)和标准INR组129例(INR目标值2.0-3.0),比较两组人口学、病情资料和出血、血栓栓塞事件发生情况,同时对比两组随访期间INR＞3.0和INR＜ 2.0的时间百分比.结果 随访过程中出血事件两组分别有9例和7例,栓塞事件分别为12例和9例,两组出血及栓塞事件年化率组间比较差异均无统计学意义(P＞0.05);两组INR＜2.0时间百分比组间比较差异无统计学意义(P＞0.05),窄INR组治疗期间INR＞2.5时间百分比和＞3.0时间百分比均低于标准INR组,组间比较差异有统计学意义(P＞0.05).结论 INR范围设为1.5-2.0能降低老年患者出血风险,同时不增加血栓栓塞事件发生率.%Objective To evaluate the efficacy of different INR target values of thrombotic events prevention in elderly patients after oral warfarin.Methods From January 2010 to January 2016,237 elderly patients who received oral warfarin anticoagulation in our hospital were retrospectively analyzed.They were divided them into narrow INR group(INR target 2.0-2.5,n =108) and standard INR group(INR target 2.0 to 3.0,n =129).The demographic,disease information and incidence of thromboembolism was compared between two groups.The time percentage of INR ＞ 3.0 and INR ＜ 2.0 was compared between two groups as well.Results There were 9 cases and 7 cases of bleeding events in the two groups.The embolization events were 12 cases and 9 cases respectively.There was no significant difference between the two groups in the bleeding and embolism events (P ＞ 0.05).There was no significant difference between the two groups (P ＞0.05).There was no significant difference in the percentage of INR ＜ 2.0 between the two groups (P ＞0.05).In INR group,INR ＞ 2.5 time percentage and ＞ 3.0 time percentage were lower than that in standard INR group,the difference was statistically significant(P ＞ 0.05).Conclusion The INR range of 1.5-2.0 can reduce the risk of bleeding in elderly patients without increasing the incidence of thromboembolic events.