一些危险因素对维生素K拮抗剂过量抗凝治疗患者过度抗凝障碍和出血的影响。

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE Vascular Health and Risk Management Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI:10.2147/VHRM.S410497
Si Dung Chu, Minh Thi Tran
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引用次数: 0

摘要

目的:研究服用维生素K拮抗剂(VKAs)抗凝药物患者过度抗凝的危险因素。方法:横断面描述性、前瞻性研究。对79名服用抗凝血药物的VKAs患者的研究,这些患者的INR(国际标准化比值)指数超过了VKAs治疗的抗凝剂量。结果:共有79例患者,平均年龄65.65±12.17岁[33:85],老年组常见(73.4%),出血性疾病患者占22.8%,INR指数平均值为5.88±3.0[3.02-23.95];INR>5水平组出血风险高于INR≤5水平组,具有统计学意义(p<0.001)。治疗血脂异常、甲状腺功能亢进、胺碘酮、β受体阻滞剂、泼尼松、非甾体抗炎药、BMI,吸烟和饮酒是服用抗凝剂时出血增加的危险因素,但尚不具有统计学意义(OR>1,p>0.05);这些使用辅酶Q10和十字花科蔬菜(十字花科、菊科)等绿色蔬菜营养的患者相当常见(31.6%和35.4%),其对维生素K凝血的影响和出血风险增加的原因具有统计学意义,分别为OR=5.28(CI:1.72-16.17,p<0.01)和OR=2.99(CI:1.01-8.80,p<0.05)。结论:抗凝过度患者多为老年人。出血性疾病患者占22.8%,INR>5水平组出血风险高于INR<5水平组,具有统计学意义。患者使用辅酶Q10和绿色蔬菜营养如十字花科蔬菜(十字花科、菊科)是相当常见的,其对凝血的影响和引起出血并发症的风险增加具有统计学意义。
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Effect of Some Risk Factors on Over-Anticoagulation Disorders and Bleeding in Patients Receiving Anticoagulant Therapy with Overdosage of Vitamin K Antagonist.

Objective: Study on effect of risk factors on over-anticoagulation in patients taking anticoagulant drugs with VKAs (vitamin K antagonists).

Methods: Cross-sectional descriptive, prospective research. Study on 79 patients taking anticoagulant drugs with VKAs who had an INR (International Normalized Ratio) index of more than indicated anticoagulation dose with VKAs therapy.

Results: A total of 79 patients, mean age 65.65 ± 12.17 years [33:85], the elderly group is common (73.4%). Patients had hemorrhage disorders account for 22.8%. The INR index had an average value was 5.88 ± 3.0 [3.02-23.95]; The INR> 5 level group is a higher risk of bleeding than the INR ≤5 level group, it's the statistical significance (p < 0.001). The risk factors such as drugs to treat dyslipidemia, hyperthyroid, amiodarone, beta blocker, prednisone, NSAIDs (Non-steroidal anti-inflammatory), BMI (Body Mass Index), smoke and alcohol that the risk factors of increasing of bleeding when receiving anticoagulants but it's not statistically significant yet (OR >1, p > 0.05); These patients using coenzyme Q10 and green vegetable nutrition such as cruciferous vegetables (Brassicaceae, Asteraceae) are quite common (31.6% and 35.4%), its effect on coagulation with vitamin K and cause of the increased in risk of bleeding was statistical significantly with OR = 5.28 (CI: 1.72-16.17, p < 0.01), and OR = 2.99 (CI: 1.01-8.80, p < 0.05) respectively.

Conclusion: Most patients in over-anticoagulation were the elderly group. Patients had hemorrhage disorders account for 22.8%. The INR> 5 level group was a higher risk of bleeding than the INR ≤5 level group with statistical significance. Patients using Coenzyme Q10 and green vegetable nutrition such as cruciferous vegetables (Brassicaceae, Asteraceae) are quite common, its effect on coagulation and cause of the increased risk of bleeding complication with statistical significance.

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来源期刊
Vascular Health and Risk Management
Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-
CiteScore
4.20
自引率
3.40%
发文量
109
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.
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