Maramba Aaron, Ncube Silenkosi, Mandisodza Arthur, Da Silva Marques Dayana, Matsikure Tsehay
Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Haematology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
TH Open. 2018 Sep 26;2(3):e325-e328. doi: 10.1055/s-0038-1672186. eCollection 2018 Jul.
Thrombophilia describes conditions that predispose individuals to increased blood clotting and includes conditions such as deep vein thrombosis and pulmonary embolism. Thrombophilia is associated with high morbidity and mortality rates, and is commonly treated by warfarin anticoagulation. However, warfarin may cause both bleeding and clotting episodes if the therapy is not monitored and managed effectively. The main objective of this study was to assess the effectiveness of warfarin monitoring systems on thrombophilic patients at a major hospital in Zimbabwe. A clinical and laboratory prospective and retrospective study was performed on patients who had been on warfarin therapy for at least 1 year. Questionnaires were administered to participants on warfarin from outpatients clinics at Parirenyatwa Group of Hospitals. Their international normalized ratio (INR) results were also accessed from the laboratory information system and captured in the and Microsoft Excel for analysis. Fifty questionnaires were administered and 47 (94%) participants responded adequately. Twenty-nine (61.1%) participants on warfarin were females. The majority of them were elderly and in the 31 to 40 age groups. Eighteen (38.3%) participants missed their medication at some point, while 12 (25.5%) had warfarin overdose. Sixteen (34%) and 11 (23.4%) admitted to taking alcohol and smoking, respectively, while on warfarin. Thirty-five (74.5%) did not change their medication nor were advised on the right diet. Thirty-four (72.3%) had appointments set after every month. Some participants indicated that they had symptoms of both clotting and bleeding. There were statistically significant differences ( < 0.0001) between INRs for 3 monthly intervals from the initiation of warfarin therapy. Women and the elderly formed the majority of the patients on warfarin, indicating gender and advanced age susceptibility to thrombophilia, respectively. The effectiveness of the warfarin monitoring systems appeared to be hampered by lack of a coordinated system that adequately monitors anticoagulant therapy in the country.
易栓症描述的是使个体易于发生血液高凝的状况，包括深静脉血栓形成和肺栓塞等病症。易栓症与高发病率和死亡率相关，通常采用华法林抗凝治疗。然而，如果治疗未得到有效监测和管理，华法林可能会导致出血和凝血事件。
本研究的主要目的是评估津巴布韦一家大型医院对华法林监测系统在易栓症患者中的有效性。
对接受华法林治疗至少1年的患者进行了一项临床和实验室前瞻性及回顾性研究。在帕里伦亚瓦医院集团的门诊诊所，向服用华法林的参与者发放了问卷。他们的国际标准化比值（INR）结果也从实验室信息系统中获取，并录入到[具体软件名称]和Microsoft Excel中进行分析。
发放了50份问卷，47名（94%）参与者做出了充分回应。服用华法林的参与者中有29名（61.1%）为女性。他们大多数是老年人，年龄在31至40岁组。18名（38.3%）参与者在某些时候漏服了药物，而12名（25.5%）出现了华法林过量。16名（34%）和11名（23.4%）参与者分别承认在服用华法林期间饮酒和吸烟。35名（74.5%）既未更换药物，也未得到正确饮食方面的建议。34名（72.3%）患者每月之后都有预约。一些参与者表示他们有凝血和出血的症状。从开始华法林治疗起，每3个月间隔的INR之间存在统计学显著差异（P < 0.0001）。
女性和老年人构成了服用华法林患者的大多数，分别表明性别和高龄对易栓症的易感性。该国缺乏一个能充分监测抗凝治疗的协调系统，这似乎阻碍了华法林监测系统的有效性。
