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Eur Heart J：远程指导极低剂量INR自控法适用于人工瓣膜置换患者

2014-09-16 高晓方 译 医学论坛网

远程指导INR自控法人工瓣膜置换患者
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德国一项研究表明，在人工心脏瓣膜置换患者中，远程指导极低剂量国际标准化比值(INR)自控方法在血栓形成风险方面与低剂量INR方法相当，出血风险则低于后者。因该研究中二尖瓣瓣置换(MVR)和双瓣膜置换(DVR)患者数量较少，因此这种方法适用于主动脉瓣置换(AVR)者。论文于9月9日在线发表于《欧洲心脏杂志》(Eur Heart J)。 此项研究纳入1304例AVR、189例MVR和78例D

德国一项研究表明，在人工心脏瓣膜置换患者中，远程指导极低剂量国际标准化比值(INR)自控方法在血栓形成风险方面与低剂量INR方法相当，出血风险则低于后者。因该研究中二尖瓣瓣置换(MVR)和双瓣膜置换(DVR)患者数量较少，因此这种方法适用于主动脉瓣置换(AVR)者。论文于9月9日在线发表于《欧洲心脏杂志》(Eur Heart J)。

此项研究纳入1304例AVR、189例MVR和78例DVR患者，并随意分入低剂量INR自控组(LOW组)或伴远程指导的极低剂量INR自控每周一次组(VLO)和每周两次组(VLT)。比较III级并发症发生率和总体死亡率。主要终点为大出血和血栓性事件，次要终点为死亡。

结果显示，LOW、VLO和VLT组的2年无出血率分别为96.3%、98.6%和99.1%(P=0.008)，相应的无血栓性事件率分别为99.0%、99.8%和98.9%(P=0.258)。在符合方案人群中，以LOW为参照组，VLO和VLT组III级并发症的危险比分别为0.307(P=0.036)和0.0241(P=0.025)。VLO和VLT组的2年死亡值分别为1.685(P=0.421)和4.70(P=0.004)。

原始出处：

Koertke H1, Zittermann A2, Wagner O3, Secer S4, Huth C5, Sciangula A6, Saggau W7, Sack FU7, Ennker J8, Cremer J9, Musumeci F10, Gummert JF2.Telemedicine-guided very low-dose international normalized ratio self-control in patients with mechanical heart valve implants.Eur Heart J. 2014 Sep 9. pii: ehu330. [Epub ahead of print]



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    2015-03-14 more is better!

    #人工瓣膜#

    0

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    2015-02-08 yxch48

    #置换#

    0

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    2015-04-10 zhaozuguo

    #INR#

    0

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    2014-09-18 zhaojie88

    #ART#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1985131, encodeId=73d619851315a, content=<a href='/topic/show?id=5f252483474' target=_blank style='color:#2F92EE;'>#人工瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24834, encryptionId=5f252483474, topicName=人工瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca6a2500099, createdName=more is better!, createdTime=Sat Mar 14 01:51:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742303, encodeId=601b1e42303b3, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Feb 08 18:51:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1933948, encodeId=d5b419339488f, content=<a href='/topic/show?id=0387988676' target=_blank style='color:#2F92EE;'>#INR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9886, encryptionId=0387988676, topicName=INR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Apr 10 07:51:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355921, encodeId=44821355921a7, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480404, encodeId=c1bd1480404f1, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562264, encodeId=73d81562264a1, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583441, encodeId=99d815834417a, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=)]
    2014-09-18 ms1292405679162969

    #低剂量#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1985131, encodeId=73d619851315a, content=<a href='/topic/show?id=5f252483474' target=_blank style='color:#2F92EE;'>#人工瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24834, encryptionId=5f252483474, topicName=人工瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca6a2500099, createdName=more is better!, createdTime=Sat Mar 14 01:51:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742303, encodeId=601b1e42303b3, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Feb 08 18:51:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1933948, encodeId=d5b419339488f, content=<a href='/topic/show?id=0387988676' target=_blank style='color:#2F92EE;'>#INR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9886, encryptionId=0387988676, topicName=INR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Apr 10 07:51:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355921, encodeId=44821355921a7, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480404, encodeId=c1bd1480404f1, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562264, encodeId=73d81562264a1, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583441, encodeId=99d815834417a, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=)]
    2014-09-18 爆笑小医

    #HEART#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1985131, encodeId=73d619851315a, content=<a href='/topic/show?id=5f252483474' target=_blank style='color:#2F92EE;'>#人工瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24834, encryptionId=5f252483474, topicName=人工瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca6a2500099, createdName=more is better!, createdTime=Sat Mar 14 01:51:00 CST 2015, time=2015-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742303, encodeId=601b1e42303b3, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Sun Feb 08 18:51:00 CST 2015, time=2015-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1933948, encodeId=d5b419339488f, content=<a href='/topic/show?id=0387988676' target=_blank style='color:#2F92EE;'>#INR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9886, encryptionId=0387988676, topicName=INR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Apr 10 07:51:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355921, encodeId=44821355921a7, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480404, encodeId=c1bd1480404f1, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562264, encodeId=73d81562264a1, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583441, encodeId=99d815834417a, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Thu Sep 18 00:51:00 CST 2014, time=2014-09-18, status=1, ipAttribution=)]
    2014-09-18 12498e5fm17(暂无昵称)

    #瓣膜#

    0