Notaridis Grigorios, Gschwind Liliane, de Moerloose Philippe, Boehlen Françoise
Unite d'hémostase, Service d'angiologie et d'hémostase, Département de médecine, HUG, 1211 Geneve 14.
Rev Med Suisse. 2010 Feb 10;6(235):292, 294-7.
Anticoagulant therapy is indicated in many clinical situations. The handling of vitamin K antagonists (VKA) is difficult and their therapeutic range is narrow, requiring close biological monitoring of INR. Introduction of VKA is a particularly critical period. Algorithms for initiation of oral anticoagulant therapy have been proposed but they are generally designed for warfarin, which has a longer half life as compared to acenocoumarol. In this article, algorithms for the prescription of acenocoumarol are proposed, taking into account the patient's age, weight and initial Quick value. The goal of these algorithms, combined with frequent monitoring of INR, is to limit the bleeding risk during the introduction of anticoagulant therapy.
抗凝治疗适用于多种临床情况。维生素K拮抗剂（VKA）的使用较为困难，其治疗窗狭窄，需要密切监测国际标准化比值（INR）的生物学指标。VKA的起始阶段尤为关键。虽然已经提出了口服抗凝治疗的起始算法，但这些算法通常是针对华法林设计的，与醋硝香豆素相比，华法林的半衰期更长。本文提出了醋硝香豆素的处方算法，同时考虑了患者的年龄、体重和初始Quick值。这些算法结合对INR的频繁监测，目的是在抗凝治疗起始阶段降低出血风险。
