Safety of intramuscular influenza immunization among patients receiving long-term warfarin anticoagulation therapy.
Safety of intramuscular influenza immunization among patients receiving long-term warfarin anticoagulation therapy.
复制标题
接受长期华法林抗凝治疗的患者肌肉注射流感免疫的安全性。
DOI：
10.1001/archinte.1995.00430140104011
复制
发表时间：
1995
影响因子：
--
通讯作者：
W. P. Mckinney
中科院分区：
文献类型：
--
作者：
G. Raj;Raminder Kumar;W. P. Mckinney
背景
流感疫苗对服用华法林的患者凝血酶原时间（PT）的影响尚不清楚，因为先前的研究显示了相互矛盾的结果，并且这种所谓影响的临床意义尚不确定。此外，据我们所知，没有数据证实接受抗凝治疗的患者肌内注射可能形成局部血肿的安全性。我们测量了流感疫苗对长期接受华法林钠治疗的患者PT的影响，并评估了肌内注射的安全性。
方法
41名正在接受抗凝治疗的成人患者肌肉注射0.5 mL流感疫苗。在基线和免疫后第3、7和14天测量凝血酶原时间和臂围。局部疼痛和压痛采用5分制进行评估。患者和研究护士对所有既往测量结果均设盲。计算每例患者的基线PT与每次后续访视时PT之间的差异以及臂围较基线的最大变化。计算整个组的平均值、范围和95%置信区间。
结果
基线与接种后第3、7和14天之间PT无统计学显著变化，臂围无显著变化。肌内注射后没有临床可检测到的局部并发症，流感疫苗接种后没有严重或轻微的出血事件。
结论
流感疫苗对正在接受华法林治疗的患者的PT无显著影响。流感疫苗可以肌肉注射给正在接受抗凝治疗的患者，没有局部出血并发症的风险。
BACKGROUND
The effect of influenza vaccine on the prothrombin time (PT) among patients taking warfarin is unclear, as previous studies have shown conflicting results and the clinical significance of such a purported effect is uncertain. Moreover, to our knowledge, there are no data confirming the safety of intramuscular injections in patients receiving anticoagulant therapy with regard to possible local hematoma formation. We measured the effect of influenza vaccine on the PT among patients receiving long-term warfarin sodium therapy and evaluated the safety of intramuscular injections among them.
METHODS
Forty-one adult patients who were receiving anticoagulant therapy were given 0.5 mL of influenza vaccine intramuscularly. Prothrombin time and arm girth were measured at baseline and on days 3, 7, and 14 after immunization. Local pain and tenderness were assessed on a five-point scale. Patients and study nurses were blinded to all prior measurements. Differences between baseline PT and that at each subsequent visit and the maximal change in arm circumference from baseline were calculated for each patient. Mean, range, and 95% confidence intervals were calculated for the entire group.
RESULTS
There was no statistically significant change in PT between baseline and days 3, 7, and 14 after vaccination, and no significant change in arm circumference was noted. There were no clinically detectable local complications after intramuscular injection and no major or minor bleeding episodes after influenza vaccination.
CONCLUSIONS
Influenza vaccine has no significant effect on the PT in patients who are being treated with warfarin. Influenza vaccine can be administered intramuscularly to patients who are receiving anticoagulant therapy without the risk of local bleeding complications.