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Article(id=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404284806030089, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.04.022, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723651200000, receivedDateStr=2024-08-15, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785824383249, onlineDateStr=2026-08-04, pubDate=1740672000000, pubDateStr=2025-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785824383249, onlineIssueDateStr=2026-08-04, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785824383249, creator=13701087609, updateTime=1785824383249, updator=13701087609, issue=Issue{id=1291404284806030089, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='4', pageStart='451', pageEnd='600', issueExtLink='null', onlineDate='null', pubDate='1740672000000', pubDateStr='2025-02-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785824374629, creator='13701087609', updateTime=1785824374629, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=556, endPage=560, ext={EN=ArticleExt(id=1291404321174843539, articleId=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Study of factors influencing the quality of warfarin anticoagulation in elderly patients with non-valvular atrial fibrillation, columnId=1246531412438966969, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Reader’s Field, runingTitle=null, highlight=null, articleAbstract=
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.

, authors=Rui LI1, 2a, Mang-mang PAN2a, Chi ZHANG2a, Long SHEN2b, Ling-cong KONG2b, Tian SHUANG2b, Xin-hua WANG2b, Zhi-chun GU2a, 3, Na WANG4, Hou-wen LIN2a, authorsList=Rui LI, Mang-mang PAN, Chi ZHANG, Long SHEN, Ling-cong KONG, Tian SHUANG, Xin-hua WANG, Zhi-chun GU, Na WANG, Hou-wen LIN, authorCompany=null, correspAuthors=Hou-wen LIN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291404321506193556, articleId=1291404320960934034, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=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, columnId=1246531414020219657, journalTitle=中国临床药理学杂志, columnName=读者园地, runingTitle=null, highlight=null, articleAbstract=
目的

探讨高龄非瓣膜性心房颤动（NVAF）患者华法林抗凝治疗质量的影响因素，并评估医师-药师联合门诊模式对改善抗凝质量的效果。

方法

本研究将接受华法林治疗的高龄NVAF患者分为医师-药师联合门诊组和普通门诊组，以评估不同抗凝管理策略对患者的影响。在此基础上，进一步将患者依据其国际标准化比值（INR）在治疗目标范围内的时间百分比（TTR）分为良好抗凝质量组（TTR≥60%）和差抗凝质量组（TTR<60%），分析2组患者的临床预后及发生的不良事件。

结果

医师-药师联合门诊组患者的平均TTR为（64.00±24.40）%，显著高于普通门诊组的（42.10±30.20）%（P<0.05）。多因素逻辑回归分析表明，合并症数量≥4种是抗凝质量不佳的独立风险因素（OR：0.44，95%CI：0.23~0.87，P<0.05），而医师-药师联合门诊模式显著提高了华法林的抗凝质量（OR：3.50，95%CI：1.85~6.60，P<0.05）。尽管在血栓栓塞和出血事件的发生率上2组均无显著性差异，但医师-药师联合模式在管理复杂患者方面显示出潜在优势。

结论

医师-药师联合门诊模式通过提供个性化的抗凝治疗方案及药物管理服务，有效改善了高龄NVAF患者的抗凝治疗质量，尤其对于合并症较多的患者具有积极影响，展现了该模式在临床实践中的重要价值。

, authors=李睿1, 2a, 潘忙忙2a, 张弛2a, 沈珑2b, 孔令璁2b, 双田2b, 王新华2b, 顾智淳2a, 3, 王娜4, 林厚文2a, authorsList=李睿, 潘忙忙, 张弛, 沈珑, 孔令璁, 双田, 王新华, 顾智淳, 王娜, 林厚文, authorCompany=null, correspAuthors=林厚文, authorNote=

李睿（1999-），女，硕士研究生，主要从事循证药学和临床药学方面的研究

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林厚文，主任药师，博士生导师 Tel: （021）68385652 E-mail:
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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
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李睿 1, 2a , 潘忙忙 2a , 张弛 2a , 沈珑 2b , 孔令璁 2b , 双田 2b , 王新华 2b , 顾智淳 2a, 3 , 王娜 4 , 林厚文 2a
中国临床药理学杂志 | 读者园地 2025,41(4): 556-560
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中国临床药理学杂志 |读者园地 2025 , 41 (4) : 556 -560
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
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李睿1, 2a, 潘忙忙2a, 张弛2a, 沈珑2b, 孔令璁2b, 双田2b, 王新华2b, 顾智淳2a, 3, 王娜4, 林厚文2a
作者信息
  • 1.上海海洋大学 食品学院，上海 201306
  • 2a.上海交通大学 医学院 附属仁济医院，药剂科，上海 200127
  • 2b.上海交通大学 医学院 附属仁济医院，心内科，上海 200127
  • 3.上海交通大学 医学院 附属仁济医院 浦南分院 药剂科，上海 201203
  • 4.重庆医科大学 第二附属医院 药剂科，重庆 400010
通讯作者:
林厚文，主任药师，博士生导师 Tel: （021）68385652 E-mail:
作者简介:

李睿（1999-），女，硕士研究生，主要从事循证药学和临床药学方面的研究

Study of factors influencing the quality of warfarin anticoagulation in elderly patients with non-valvular atrial fibrillation
Rui LI1, 2a, Mang-mang PAN2a, Chi ZHANG2a, Long SHEN2b, Ling-cong KONG2b, Tian SHUANG2b, Xin-hua WANG2b, Zhi-chun GU2a, 3, Na WANG4, Hou-wen LIN2a
Affiliations
  • 1.School of Food Science, Shanghai Ocean University, Shanghai 201306, China
  • 2a.Department of Pharmacy, Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • 2b.Department of Cardiology, Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • 3.Department of Pharmacy, Punan Branch of Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201203, China
  • 4.Department of Pharmacy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
出版时间: 2025-02-28 doi: 10.13699/j.cnki.1001-6821.2025.04.022
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摘要
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目的

探讨高龄非瓣膜性心房颤动（NVAF）患者华法林抗凝治疗质量的影响因素，并评估医师-药师联合门诊模式对改善抗凝质量的效果。

方法

本研究将接受华法林治疗的高龄NVAF患者分为医师-药师联合门诊组和普通门诊组，以评估不同抗凝管理策略对患者的影响。在此基础上，进一步将患者依据其国际标准化比值（INR）在治疗目标范围内的时间百分比（TTR）分为良好抗凝质量组（TTR≥60%）和差抗凝质量组（TTR<60%），分析2组患者的临床预后及发生的不良事件。

结果

医师-药师联合门诊组患者的平均TTR为（64.00±24.40）%，显著高于普通门诊组的（42.10±30.20）%（P<0.05）。多因素逻辑回归分析表明，合并症数量≥4种是抗凝质量不佳的独立风险因素（OR：0.44，95%CI：0.23~0.87，P<0.05），而医师-药师联合门诊模式显著提高了华法林的抗凝质量（OR：3.50，95%CI：1.85~6.60，P<0.05）。尽管在血栓栓塞和出血事件的发生率上2组均无显著性差异，但医师-药师联合模式在管理复杂患者方面显示出潜在优势。

结论

医师-药师联合门诊模式通过提供个性化的抗凝治疗方案及药物管理服务，有效改善了高龄NVAF患者的抗凝治疗质量，尤其对于合并症较多的患者具有积极影响，展现了该模式在临床实践中的重要价值。

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
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.

warfarin  /  elderly non-valvular atrial fibrillation  /  anticoagulant quality  /  combined physician-pharmacist outpatient  /  thromboembolism and bleeding
李睿, 潘忙忙, 张弛, 沈珑, 孔令璁, 双田, 王新华, 顾智淳, 王娜, 林厚文. 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. 中国临床药理学杂志, 2025 , 41 (4) : 556 -560 . DOI: 10.13699/j.cnki.1001-6821.2025.04.022
Rui LI, Mang-mang PAN, Chi ZHANG, Long SHEN, Ling-cong KONG, Tian SHUANG, Xin-hua WANG, Zhi-chun GU, Na WANG, Hou-wen LIN. Study of factors influencing the quality of warfarin anticoagulation in elderly patients with non-valvular atrial fibrillation[J]. Chinese Journal of Clinical Pharmacology, 2025 , 41 (4) : 556 -560 . DOI: 10.13699/j.cnki.1001-6821.2025.04.022
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  • 上海市科学技术委员会基金资助项目(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)
  • 上海申康医院发展中心基金资助项目(SHDC2022CRS035)
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2025年第41卷第4期
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doi: 10.13699/j.cnki.1001-6821.2025.04.022
  • 接收时间：2024-08-15
  • 首发时间：2026-08-04
  • 出版时间：2025-02-28
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  • 收稿日期：2024-08-15
基金
上海市科学技术委员会基金资助项目(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)
上海申康医院发展中心基金资助项目(SHDC2022CRS035)
作者信息
    1.上海海洋大学 食品学院，上海 201306
    2a.上海交通大学 医学院 附属仁济医院，药剂科，上海 200127
    2b.上海交通大学 医学院 附属仁济医院，心内科，上海 200127
    3.上海交通大学 医学院 附属仁济医院 浦南分院 药剂科，上海 201203
    4.重庆医科大学 第二附属医院 药剂科，重庆 400010

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林厚文，主任药师，博士生导师 Tel: （021）68385652 E-mail:
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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2025.04.022
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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