今日药学

2017, v.27(12) 836-838

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1例人工心脏瓣膜术后合并白塞病患者华法林疗效减弱的原因分析
Analysis of the Causes for the Reduced Efficacy of Warfarin in a Artificial Heart Valve Postoperative Patient with Behcet's Disease

何芳玲,谢又佳,谢菲
HE Fangling,XIE Youjia,XIE Fei

摘要(Abstract):

目的临床药师通过参与1例人工心脏瓣膜术后合并白塞病患者的治疗过程,探讨其华法林疗效减弱的原因。方法临床药师参与患者治疗的过程,从白塞病、药物相互作用、体重指数、遗传或其他获得性因素对华法林的影响进行分析,探讨其华法林疗效减弱的主要原因。结果药物相互作用(主要是糖皮质激素、托拉塞米)及体重指数增加而未及时监测国际标准化比值(INR)并调整华法林剂量是患者华法林疗效减弱的主要原因。结论临床药师从专业角度出发,协助医生分析问题,可为今后类似患者的治疗提供参考。
OBJECTIVE Clinical pharmacists explore the reasons for the reduced efficacy of Warfarin in a artificial heart valve postoperative patient with Behcet' s disease through participation in treatment planning. METHODS Through analyze of Behcet' s disease,drug interactions,body mass index,genetic or other acquired factors impact on Warfarin. Clinical pharmacists analyzed the main reason for the decreased efficacy of Warfarin in the course of treatment. RESULTS The main reason for the decreased efficacy of Warfarin was the combination of drug interactions( mainly including glucocorticoids and torsemide),and an increase in body mass index without timely monitoring the International Normalized Ratio( INR) and adjusting the dose of Warfarin. CONCLUSION Clinical pharmacists should help doctors to analyze and solve problems from their own professional point of view. This can provide a reference for the treatment of similar patients in the future.

关键词(KeyWords): 华法林;疗效减弱;人工心脏瓣膜术后;白塞病
Warfarin;reduced efficacy;artificial heart valve postoperative;Behcet's disease

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作者(Author): 何芳玲,谢又佳,谢菲
HE Fangling,XIE Youjia,XIE Fei

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