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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。
Objective To understand the frequency of outpatient INR monitoring and INR reach the ideal range in patients taking warfarin, and provide the basis for clinicians to adjust drug dose and follow-up management. Methods From January 1 to December 31, 2013, all patients who took warfarin and who undergone INR (International Standardized Measurement) were enrolled in the first hospital outpatient laboratory system in Handan. The data included the case number, name, sex , Age, illness, INR measure. Results Within 1 year, a total of 931 INR records were obtained. Including 411 patients, average age (57.3 ± 13.7) years, 46.2% of men and 53.8% of women. One of the 198 patients (48.2%) had an INR measurement, and only 17.3% of patients measured more than 4 INRs, with the highest rate of heart valve surgery patients having more than 4 measurements (27.3%). Based on the last INR measurement, 42.8% of patients with an INR in the 2.0 to 3.0 range and 35.2% of 213 patients who measured more than 2 INR had monthly INR values of 44.6% More than half of patients with INR measurements are within the standard range of 2.0 to 3.0. 931 people INR measurements, INR 2.0 to 3.0 accounted for 38.7%. Patients with heart valve surgery achieve higher INR levels. Conclusion The anticoagulant-treated patients have a low monthly rate of INR measurement, out-patient INR rate up to 40.0%, and valvular surgery patients with higher INR rate.