病因心房颤动患者使用抗糖药物的安全

Juniarto Mende, Fita Rahmawati, Ika Puspitasari
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摘要

心房颤动可因左心房淤血而导致中风,从而引发血栓形成和脑栓塞。使用抗凝血剂是为了防止血栓形成,以防止中风的发生,但另一方面,它与出血副作用的风险有关。本研究旨在评估抗凝药物治疗缺血性中风伴心房颤动患者的安全性。该研究采用了横断面设计。回顾性数据取自日惹RSUP Sardjito医生2018年1月至2020年12月期间的医疗记录。研究对象为伴有心房颤动的缺血性中风患者。抗凝血剂的安全性评估包括每种抗凝血剂中主要和次要出血事件的数量以及影响出血发生的因素。共有70名患者符合研究纳入标准。出血41例(58.57%)。大出血28例(40%),小出血13例(18,57%)。导致出血的最常见的抗凝剂是华法林。影响肾衰竭出血发生因素的多因素检验(OR=5990;95%CI 2002-17920;p=0.001)。监测抗凝血剂,尤其是华法林的副作用是必要的。药剂师可以通过考虑危险因素,特别是肾衰竭,在监测和预防出血事件方面发挥重要作用。
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Keamanan Penggunaan Antiglukolan pada Pasien Rawat Inap Stroke Iskemik dengan Atrial Fibrilasi
Atrial fibrillation can cause stroke due to blood stasis in the left atrium which triggers thrombus formation and embolization of the brain. Administration of anticoagulants is used to prevent clot formation to prevent the occurrence of stroke, but on the other hand, it is associated with the risk of bleeding side effects. This study aims to evaluate the safety of anticoagulants in ischemic stroke patients with atrial fibrillation. The study used a cross-sectional design. Retrospective data were taken from the medical records of RSUP Dr. Sardjito, Yogyakarta period January 2018 to December 2020. The research subjects were ischemic stroke patients with atrial fibrillation. Evaluation of the safety of anticoagulants includes the number of major and minor bleeding events in each type of anticoagulant and the factors that influence the occurrence of bleeding. A total of 70 patients met the study inclusion criteria. Bleeding occurred in 41 cases (58,57%). Major bleeding was 28 patients (40%) and minor bleeding was 13 patients (18,57%). The most common anticoagulant that causes bleeding is warfarin. Multivariate test of the factors that influence the occurrence of bleeding in kidney failure (OR = 5,990; 95% Cl 2,002-17,920; p = 0,001). Monitoring the side effects of anticoagulants, especially warfarin is necessary. Pharmacists can play an important role in monitoring and preventing bleeding events by taking into account risk factors, especially kidney failure.
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