Chikada M, Yagyu K, Kotsuka Y, Furuse A
Department of Thoracic Surgery, Tokyo University, Japan.
Kyobu Geka. 1994 Oct;47(11):895-8.
We compared the efficacy and complications of anticoagulation with warfarin in 98 patients after isolated mitral valve replacement (MVR 57 pts) and isolated aortic valve replacement (AVR 41 pts). Fifty Medtronic-Hall valves, 33 St. Jude Medical valves, 9 Björg-Shiley valves and 6 other valves were used. In 1991, we made our control standard of prothrombin-time (%) between 25% and 35% (INR 2.3-3.1) and in 1992, between 30% and 40% (INR 2.1-2.8), although INR recommended by ACCP in 1988 was 3 to 4.5. In 1991, mean PT (%) was 31.2% and mean INR was 2.75 in our patients. In 1992, mean PT (%) was 35.0% and mean INR was 2.53. In 1991, we experienced bleeding episodes in three patients and thromboembolism in one case. In 1992, no complication occurred. We conclude that anticoagulant therapy of mean INR 2.53 seemed to be more suitable for Japanese patients than the ACCP standard.
我们比较了98例单纯二尖瓣置换术（MVR，57例）和单纯主动脉瓣置换术（AVR，41例）患者使用华法林抗凝的疗效及并发症。共使用了50个美敦力-霍尔瓣膜、33个圣犹达医疗瓣膜、9个比约格-希利瓣膜和6个其他瓣膜。1991年，我们将凝血酶原时间（%）的控制标准设定为25%至35%（国际标准化比值INR为2.3至3.1），1992年设定为30%至40%（INR为2.1至2.8），尽管1988年美国胸科医师学会（ACCP）推荐的INR为3至4.5。1991年，我们的患者平均凝血酶原时间（%）为31.2%，平均INR为2.75。1992年，平均凝血酶原时间（%）为35.0%，平均INR为2.53。1991年，我们有3例患者发生出血事件，1例发生血栓栓塞。1992年，未发生并发症。我们得出结论，对于日本患者，平均INR为2.53的抗凝治疗似乎比ACCP标准更合适。
