Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Cell Biochem Biophys. 2012 Jan;62(1):147-51. doi: 10.1007/s12013-011-9275-4.
The purpose of this study was to define the optimal international normalized ratio (INR) intensity of oral anticoagulant therapy in Chinese patients with valve replacement surgery. We studied 1,658 patients who underwent mechanical valve replacement in Beijing Anzhen Hospital; the focus of the study was on correlation between intensity of anticoagulant therapy and thromboembolism/hemorrhage complications. We further followed up 1,508 patients for 46 ± 16 months (range 1-61 months). Average INR was 2.13 ± 0.56, and warfarin dose was 3.09 ± 0.85 mg/day. The incidence rate of anticoagulation-related thromboembolism was 1.17 per 100 patient-years (%/pt-y), and the incidence rate of anticoagulation-related hemorrhage was 2.02%/pt-y. The incidence rate of total complications (i.e., combined thromboembolism and hemorrhages) was 3.24%/pt-y. The rate of total complications in group on INR 1.3-2.3 (aortic valve replacement: 1.3-1.8; mitral valve replacement and double valve replacement: 1.8-2.3) was the lowest among all anticoagulant therapy regimens followed. In conclusion, the relatively low anticoagulant strategy presented above efficiently prevents thrombosis and hemorrhage complications.
本研究旨在确定中国瓣膜置换手术患者口服抗凝治疗的最佳国际标准化比值（INR）强度。我们研究了在北京安贞医院接受机械瓣膜置换术的 1658 名患者；研究重点是抗凝治疗强度与血栓栓塞/出血并发症之间的相关性。我们进一步对 1508 名患者进行了 46±16 个月（1-61 个月）的随访。平均 INR 为 2.13±0.56，华法林剂量为 3.09±0.85mg/天。抗凝相关血栓栓塞的发生率为 1.17/100 患者年（%/pt-y），抗凝相关出血的发生率为 2.02%/pt-y。总并发症（即血栓栓塞和出血的合并症）的发生率为 3.24%/pt-y。INR 为 1.3-2.3 组（主动脉瓣置换：1.3-1.8；二尖瓣置换和双瓣置换：1.8-2.3）的总并发症发生率在所有抗凝治疗方案中最低。总之，上述相对较低的抗凝策略可有效预防血栓形成和出血并发症。
