Mladenov Boris Seryozhev, Mariyanovski Valeri, Hadzhiyska Valeria
UMHATEM "Pirogov", Sofia, Bulgaria.
University Hospital Alexandrovska, Medical University, Sofia, Bulgaria.
Cent European J Urol. 2015;68(3):330-3. doi: 10.5173/ceju.2015.658. Epub 2015 Sep 26.
Visible hematuria is not rare in patients on anticoagulant therapy. There is no consensus regarding the diagnostic approach for them; some authors suggest restricted volume of diagnostic procedures because of the low number of urological etiology found. Some antibiotics have been reported to potentiate the effect of oral anticoagulants.
The study addresses the need for urological assessment of patients on anticoagulation therapy and the possible role of some drugs administrated simultaneously with an oral anticoagulant, for the onset of macroscopic hematuria. Patients hospitalized with hematuria, both with or without anticoagulation therapy, were investigated and followed up.
The onset of hematuria depends on the monitoring of oral anticoagulation. INR (International Normalized Ratio) value corresponds with the probability of non-urological etiology, where INR>4 carries relatively low risk for urological and malignant etiology. Some antibiotics may influence the anticoagulation effect, so INR value may be elevated and hematuria may occur.
Anticoagulation therapy should be administrated carefully and individually. The risk of urological etiology of hematuria is lower in patients on oral anticoagulants (especially when INR >4), however, it is not zero.
肉眼血尿在接受抗凝治疗的患者中并不罕见。对于他们的诊断方法尚无共识；一些作者建议限制诊断程序的数量，因为发现的泌尿系统病因数量较少。据报道，一些抗生素会增强口服抗凝剂的作用。
本研究探讨了对抗凝治疗患者进行泌尿外科评估的必要性，以及与口服抗凝剂同时使用的某些药物在肉眼血尿发生中的可能作用。对因血尿住院的患者进行了调查和随访，这些患者无论是否接受抗凝治疗。
血尿的发生取决于口服抗凝治疗的监测。国际标准化比值（INR）值与非泌尿系统病因的概率相对应，其中INR>4时泌尿系统和恶性病因的风险相对较低。一些抗生素可能会影响抗凝效果，因此INR值可能会升高，进而可能出现血尿。
抗凝治疗应谨慎且个体化给药。口服抗凝剂患者血尿的泌尿系统病因风险较低（尤其是当INR>4时），然而，这并非为零。
