Yasar Ayse Saatci, Balbay Yucel, Maden Orhan, Sasmaz Hatice
Turkiye Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey.
J Heart Valve Dis. 2007 Mar;16(2):200-2.
Warfarin, an oral anticoagulant, is the therapy of choice to maintain anticoagulation. An individual requiring five- to 20-fold higher dosage than average for anticoagulation may be considered as having resistance to warfarin. In order to evaluate a subtherapeutic response to high-dose warfarin, the clinician must consider many possible causes of resistance, such as non-compliance, drug interactions, or pharmacokinetic changes. When these factors have been eliminated, an hereditary warfarin resistance might be considered responsible. The case is reported of a 49-year-old woman who received warfarin after mitral valve replacement and experienced mechanical mitral valve thrombosis due to inadequate anticoagulation, possibly caused by warfarin resistance.
华法林是一种口服抗凝剂，是维持抗凝治疗的首选药物。对于抗凝治疗所需剂量比平均剂量高5至20倍的个体，可被视为对华法林耐药。为了评估高剂量华法林治疗效果不佳的情况，临床医生必须考虑许多可能导致耐药的原因，如不依从、药物相互作用或药代动力学变化。当这些因素被排除后，可能认为存在遗传性华法林耐药。本文报告了一例49岁女性病例，该患者在二尖瓣置换术后接受华法林治疗，因抗凝不足发生机械性二尖瓣血栓形成，可能是由华法林耐药所致。
