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抗凝治疗水平的控制及相关因素:一项前瞻性队列研究。

Control of Therapeutic Levels of Anticoagulation and Associated Factors: A Prospective Cohort Study.

机构信息

University of Girona, Girona, Spain.

Health and Health Care Research Group, Girona, Spain.

出版信息

J Prim Care Community Health. 2022 Jan-Dec;13:21501319221129935. doi: 10.1177/21501319221129935.

Abstract

Maintaining therapeutic levels of anticoagulation is essential to avoid health complications in people who take vitamin K antagonists. This study aimed to analyze the influence of people's characteristics and the presence of changes in their lives in the control of therapeutic levels of anticoagulation. A longitudinal multicenter study with a 1-year follow-up of a cohort of 199 people receiving anticoagulant therapy was performed. The effect of biological, clinical, social, lifestyle, and changes in life on the international normalized ratio (INR) was analyzed. During the follow-up, 46.7% of participants presented good INR control. At baseline, a diagnosis of atrial fibrillation ( = .00), the lack of comorbidities ( = .03), absence of depression ( = .04), and not following a pharmacological treatment with hypoglycemia drugs ( = .01) were associated with good INR control. During the follow-up, the variable of making changes to the usual diet was associated with poor INR control ( = .05). In the binary multiple regression model, factors associated with poor control were taking hypoglycemia drugs ( = .02) and the presence of depression ( = .04), and only the diagnosis of atrial fibrillation was associated with good control ( = .03). People with a diagnosis of atrial fibrillation had good INR control. Having comorbidities, suffering depression, taking hypoglycemia drugs, and making changes to the diet have a negative effect on INR control.

摘要

维持抗凝治疗的治疗水平对于避免服用维生素 K 拮抗剂的患者出现健康并发症至关重要。本研究旨在分析患者特征和生活变化对抗凝治疗治疗水平控制的影响。对接受抗凝治疗的 199 人的队列进行了为期 1 年的纵向多中心研究。分析了生物学、临床、社会、生活方式和生活变化对国际标准化比值(INR)的影响。在随访期间,46.7%的参与者 INR 控制良好。在基线时,心房颤动的诊断( = .00)、无合并症( = .03)、无抑郁( = .04)和未接受低血糖药物的药物治疗( = .01)与良好的 INR 控制相关。在随访期间,饮食常规改变的变量与 INR 控制不佳相关( = .05)。在二元多变量回归模型中,与控制不佳相关的因素是服用低血糖药物( = .02)和存在抑郁( = .04),只有心房颤动的诊断与控制良好相关( = .03)。诊断为心房颤动的患者 INR 控制良好。存在合并症、抑郁、服用低血糖药物和改变饮食对 INR 控制有负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed3d/9623388/1daf3151f3b9/10.1177_21501319221129935-fig1.jpg

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