Bradbury M J E, Taylor G, Short P, Williams M D
Department of Haematology, The Birmingham Children's Hospital NHS Trust, Birmingham, UK.
Arch Dis Child. 2008 Apr;93(4):303-6. doi: 10.1136/adc.2006.113886. Epub 2007 Aug 3.
Capillary whole-blood point-of-care prothrombin-INR (PT-INR) testing at home is an alternative to hospital-based monitoring for patients on lifelong warfarin.
To retrospectively assess the safety and efficacy of home point-of-care testing for children on long-term warfarin.
All patients who had been on point-of-care home monitoring for at least 6 months were included in the study. Their warfarin control was assessed while on home monitoring and compared to that achieved in a similar period before changing from hospital monitoring.
Thirty-seven patients were studied for a mean of 1.0 year on clinic monitoring and 1.07 years on home monitoring. The clinic monitoring tests were within a therapeutic range for a median 70.0 (inter-quartile range 34.5) and the home monitoring were within range for median 75.0 (inter-quartile range 44.5). There were no major haemorrhagic or thrombotic complications in either group during the study period. Only 2.3% of all tests had an INR greater than 6.0 with no statistical differences seen between the clinic and home monitoring groups.
Home point-of-care testing in children on lifelong warfarin is safe, effective and offers a number of advantages to the child and family. Ongoing training and support for the families is essential for this service.
对于长期服用华法林的患者，在家进行毛细血管全血即时凝血酶原国际标准化比值（PT-INR）检测是替代医院监测的一种选择。
回顾性评估长期服用华法林儿童在家进行即时检测的安全性和有效性。
所有接受即时家庭监测至少6个月的患者纳入本研究。在家庭监测期间评估他们的华法林控制情况，并与从医院监测转换前类似时期的情况进行比较。
37例患者接受了平均1.0年的门诊监测和1.07年的家庭监测。门诊监测的检测结果在治疗范围内的中位数为70.0（四分位间距34.5），家庭监测的检测结果在治疗范围内的中位数为75.0（四分位间距44.5）。研究期间两组均未出现重大出血或血栓形成并发症。所有检测中只有2.3%的INR大于6.0，门诊和家庭监测组之间未见统计学差异。
长期服用华法林儿童的家庭即时检测是安全、有效的，对儿童及其家庭有诸多益处。持续为家庭提供培训和支持对这项服务至关重要。
