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目的结合基因型检测为患者提供合理的华法林个体化抗凝治疗。方法通过参与1例因心房颤动发作、肺部感染加重、心功能不全的老年女性患者抗凝治疗过程,分析国际标准化比值(INR)升高的原因,结合基因型结果(CYP2C9*1/*1和VKORC1-1639GA)调整华法林剂量,并进行用药教育以加强自我抗凝管理。结果与结论患者病情好转出院,出院前1天INR为1.46且处于上升趋势。临床可结合患者伴随疾病、合并用药、饮食等因素,在基因型检测指导下,缩短INR达标时间,提高抗凝治疗的有效性和安全性。
Objective To provide rational warfarin-based anticoagulant therapy for patients with genotype detection. Methods The causes of anticoagulant therapy in elderly female patients with atrial fibrillation, aggravating lung infections and cardiac insufficiency were analyzed. The causes of the increase in international normalized ratio (INR) were analyzed. Combined with genotypic results (CYP2C9 * 1 / * 1 And VKORC1-1639GA) adjusted warfarin dose, and medication education to enhance self-anticoagulation management. RESULTS AND CONCLUSIONS Patients were better discharged and discharged. The INR was 1.46 on the day before discharge and was on an upward trend. Clinic can be combined with patients with diseases, combined medication, diet and other factors, under the guidance of genotype detection, shorten the INR target time and improve the effectiveness and safety of anticoagulant therapy.