中国临床药理学杂志2025，Vol.41Issue(4)：556-560,5.DOI:10.13699/j.cnki.1001-6821.2025.04.022
高龄非瓣膜性心房颤动患者华法林抗凝质量的影响因素研究
Study of factors influencing the quality of warfarin anticoagulation in elderly patients with non-valvular atrial fibrillation
摘要
Abstract
Objective To investigate the factors affecting the quality of warfarin anticoagulation therapy in elderly patients with nonvalvular atrial fibrillation(NVAF)and to assess the effect of the combined physician-pharmacist outpatient model on improving the quality of anticoagulation.Methods In this study,elderly NVAF patients treated with warfarin were divided into combined physician-pharmacist outpatient group and general outpatient group to assess the impact of different anticoagulation management strategies on patients.On this basis,patients were further classified into good anticoagulation quality group(TTR ≥60％)and poor anticoagulation quality group(TTR＜60％)based on the percentage of time(TTR)that their international normalised ratio(INR)was within the therapeutic target range,and the clinical prognosis and adverse events that occurred in both groups were analysed.Results The mean TTR of patients in the combined physician-pharmacist outpatient group was(64.00±24.40)％,which was significantly higher than that of the general outpatient group,which was(42.10±30.20)％(P＜0.05).Multifactorial logistic regression analysis showed that the number of comorbidities≥4 was an independent risk factor for poor anticoagulation quality(OR:0.44,95％CI:0.23-0.87,P＜0.05),whereas the combined physician-pharmacist outpatient clinic model significantly improved the anticoagulation quality of warfarin(OR:3.50,95％CI:1.85-6.60,P＜0.05).Although there were no significant differences between the two groups in the incidence of thromboembolic and bleeding events,the model showed potential advantages in the management of complex patients.Conclusion The combined physician-pharmacist outpatient model effectively improves the quality of anticoagulation therapy in elderly patients with NVAF by providing personalized anticoagulation treatment plans and medication management services.This model has a particularly positive impact on patients with multiple comorbidities,demonstrating its significant value in clinical practice.关键词
华法林/高龄非瓣膜性心房颤动/抗凝质量/医师-药师联合门诊/血栓栓塞与出血Key words
warfarin/elderly non-valvular atrial fibrillation/anticoagulant quality/combined physician-pharmacist outpatient/thromboembolism and bleeding分类
医药卫生引用本文复制引用
李睿,林厚文,潘忙忙,张弛,沈珑,孔令璁,双田,王新华,顾智淳,王娜..高龄非瓣膜性心房颤动患者华法林抗凝质量的影响因素研究[J].中国临床药理学杂志,2025,41(4):556-560,5.基金项目
上海市科学技术委员会基金资助项目(23Y11902800) （23Y11902800）
上海市浦东新区卫生健康委员会卫生科技基金资助项目(PW2023D-10) （PW2023D-10）
上海申康医院发展中心基金资助项目(SHDC2022CRS035) （SHDC2022CRS035）
