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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Superiority of Fixed-dose Warfarin for Chronic Anticoagulation
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Superiority of Fixed-dose Warfarin for Chronic Anticoagulation

机译：固定剂量华法林对慢性抗凝的优越性

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Background: Long-term anticoagulation for stroke prevention is a labor-intensive endeavor, requiring close monitoring of patients to maintain efficacy and avoid toxicity. Theoretically, fixed daily doses of warfarin may facilitate the establishment and maintenance of anticoagulation, with lesser fluctuations of the international normalized ratio (INR), and favor long-term compliance. This pilot project aimed at assessing the potential advantages of fixed daily dosing for chronic anticoagulation. Methods: We compared the experiences of two separate practices within the same institution. Clinic A exclusively uses fixed daily doses. Clinic B allows the use of variable doses. The anticoagulation records of 96 patients (47 from clinic A and 49 from Clinic B) were reviewed. The incidences of INRs outside target range, occurrence of dose changes or interventions, and magnitude of dose changes were recorded at 1, 3, 6, 9 and 12 months after the institution of anticoagulation. Data were analyzed using Chi square analysis. Results: The demographic characteristics of both groups were comparable. Of the 576 INRs recorded during a period of 12 months, 316 were outside target range. There were 126 INRs outside target range in group A and 190 in group B (P < .0001). Group B accounted for 103 of the 169 dose changes resulting from an INR outside target range, whereas group A accounted for 66 (P < .05). The number of interventions and magnitude of dose changes were similar in both groups. Conclusion: Fixed daily dosing offers several advantages over variable dosing in maintaining anticoagulation.
机译：背景：长期预防卒中的抗凝是一项劳动密集型的工作，需要密切监测患者以保持疗效并避免毒性。从理论上讲，每日固定剂量的华法林可以促进抗凝的建立和维持，国际标准化比率（INR）的波动较小，有利于长期依从性。该试验项目旨在评估每日固定剂量用于慢性抗凝治疗的潜在优势。方法：我们比较了同一机构中两种不同实践的经验。诊所A仅使用固定的每日剂量。诊所B允许使用可变剂量。回顾了96例患者的抗凝记录（47例来自诊所A，49例来自诊所B）。在抗凝治疗后1、3、6、9和12个月记录了INR超出目标范围的发生率，剂量变化或干预措施的发生以及剂量变化的幅度。使用卡方分析分析数据。结果：两组的人口统计学特征具有可比性。在12个月内记录的576印度卢比中，有316卢比超出了目标范围。 A组中有126卢比超出目标范围，B组中有190卢比（P <.0001）。在INR超出目标范围的情况下，B组占169种剂量变化的103种，而A组占66种（P <.05）。两组的干预次数和剂量变化幅度相似。结论：固定剂量的每日剂量在维持抗凝方面优于可变剂量。

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