将抗凝剂调整为假体血栓性和患者风险因素. 对Medtronic的大厅门的建议
E G Butchart1, P A Lewis, J A Bethel
1Department of Cardiac Surgery, University Hospital, Cardiff, Wales, UK.
Circulation
|November 1, 1991
概括
对于Medtronic大厅患者来说,在关节置换 (MVR) 后,国际规范比率 (INR) 为3.0是最优的,而在主动脉置换 (AVR) 后,2.5是最好的. 脑卒中风险因素影响了这些建议.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 临床试验 临床试验
背景情况:
- 梅特罗尼克大厅机械门广泛用于心脏门更换.
- 确定最佳的抗凝血水平对于患者的安全和门功能至关重要.
- 之前的研究表明,机械门的抗凝点不同.
研究的目的:
- 为了确定Medtronic大厅的最佳抗凝水平 (国际标准化比率 (INR)).
- 在米特拉置换 (MVR) 和大动脉置换 (AVR) 后,在不同的INR水平下比较无事件生存率.
主要方法:
- 一项回顾性研究分析了345名MVR和241名AVR患者使用Medtronic大厅门.
- 患者被分为低 (平均INR2.5) 和中等 (平均INR3.0) 抗凝血组.
- 无事件生存期 (血栓塞,栓塞,出血) 计算在3年内.
主要成果:
- 在任何组中都没有发生膜血栓形成.
- 中心置换 (MVR):中度抗凝药 (INR 3.0) 显示3年后无事件生存率 (89%) 比低 (80%) 高.
- 大动脉置换 (AVR):低抗凝率 (INR 2.5) 显示较高的无事件存活率 (99%) 与中度 (87%) 相比,栓塞和出血事件较少.
结论:
- 麦德特朗尼大厅的最佳INR为3.0在MVR后和2.5在AVR后.
- 脑卒中风险因素需要个性化的抗凝剂调整.
- 没有中风风险因素的患者,无论抗凝血强度如何,都没有出现血栓事件.
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