Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Semin Thromb Hemost. 2009 Sep;35(6):560-7. doi: 10.1055/s-0029-1240016. Epub 2009 Sep 28.
Most patients with atrial fibrillation need anticoagulant treatment with vitamin K antagonists for prevention of thromboembolism, in particular ischemic stroke. Many studies show the efficacy of this treatment but also that it is difficult to keep patients who use vitamin K antagonists in the proper treatment range. Both a too low and a too high intensity of anticoagulation significantly increase the risk of adverse events. Hence repeated monitoring of the intensity of anticoagulation and dose adjustments are required. Management strategies that improve the time in the therapeutic target range are computer-assisted dosing algorithms and centralized care in anticoagulation clinics. In addition, self-testing of the international normalized ratio and self-dosing of vitamin K antagonists has been introduced over the past 20 years and has been shown to be an effective and safe treatment modality.
大多数房颤患者需要抗凝治疗，使用维生素 K 拮抗剂预防血栓栓塞，特别是缺血性脑卒中。许多研究表明了这种治疗的疗效，但也表明很难让使用维生素 K 拮抗剂的患者保持在适当的治疗范围内。抗凝强度过低和过高都会显著增加不良事件的风险。因此，需要反复监测抗凝强度并调整剂量。改善治疗目标范围内时间的管理策略包括计算机辅助剂量算法和抗凝诊所的集中护理。此外，过去 20 年来，国际标准化比值的自我检测和维生素 K 拮抗剂的自我给药已经被引入，并且已经被证明是一种有效和安全的治疗方式。
