张掖地区房颤患者应用华法林初始剂量与INR达标时间的研究
Study on Initial Warfarin Dose and INR Standard Time of Patients with Atrial Fibrillation in Zhangye Area

目的：研究张掖地区房颤患者INR达标时间最短的华法林起始量，及口服华法林治疗的维持量。方法：选取2019年12月01日至2020年12月31日在河西学院附属张掖人民医院住院治疗的房颤患者，进行CHA2DS2-VASc评分，选取CHA2DS2-VASc评分 ≥ 2分、HAS-BLED评分 < 3分的初次抗凝治疗的房颤患者81例，其中分成ABC三组，A组(口服华法林2.25 mg)、B组(口服华法林3.0 mg)、C组(口服华法林3.75 mg)。监测3组血浆凝血酶原时间(PT)，对比3组INR达标的时间及稳定的时间。结果：第三组比第一、二组提早达标，第一、二组达标时间无统计学差异；第二组比第一、第三组早稳定(P < 0.05)，第一、三组稳定时间无统计学差异(P > 0.05)。结论：张掖地区房颤患者华法林的最佳起始剂量为3.75 mg，维持剂量为3 mg。
Objective: To study the initial amount of warfarin in patients with atrial fibrilliation with the shortest time to reach INR standard and the maintenance of oral warfarin therapy in Zhangye area. Methods: Patients with atrial fibrillation who were hospitalized in Zhangye People’s Hospital affiliated to Hexi University from December 1, 2019 to December 31, 2020 were selected. The CHA2DS2-VASc score was conducted, and 81 patients with atrial fibrillation receiving initial anticoagulant therapy with CHA2DS2-VASc score ≥ 2 and HAS-BLED score < 3 were selected, which were divided into three groups, ABC. Group A (oral warfarin 2.25 mg), Group B (oral warfarin 3.0 mg), Group C (oral warfarin 3.75 mg). Plasma prothrombin time (PT) of the three groups was monitored, and the time of INR reaching the standard and stabilizing was compared among the three groups. Results: The third group reached the standard earlier than the first and second groups, and there was no statistical difference in the standard time of the first and second groups. The second group was stabilized earlier than the first and third groups (P ？ 0.05), and there was no statistical difference in the stabilization time between the first and third groups (P > 0.05). Conclusion: The optimal initial dose of warfarin in patients with atrial fibrilliation in zhangye area is 3.75 mg and maintenance agent is 3 mg.