摘要
目的评价SAMe-TT 2R 2评分对非瓣膜性房颤使用华法林的患者中的抗凝疗效的评估作用,探讨SAMe-TT 2R 2评分与缺血性卒中事件、出血事件的相关性。方法以石河子大学医学院第一附属医院2018年1月—2019年1月住院治疗,确诊为非瓣膜性房颤并口服华法林抗凝的患者作为观察对象,进行为期10月的随访。通过患者的国际标准化比值(INR),计算患者的抗凝治疗范围内时间百分比(Time in Therapeutic Range,TTR),并对所有患者进行SAMe-TT 2R 2评分。运用χ2检验、Spearman秩相关、ROC曲线分析评估SAMe-TT 2R 2评分对患者抗凝疗效的预测能力。随访期内收集缺血性卒中和出血事件的发生情况,分析上述事件与SAMe-TT 2R 2评分的相关性。结果190例患者平均TTR为(46.76±21.99)%,SAMe-TT 2R 2分数与患者的TTR呈负相关(P=0.001),ROC曲线下面积为0.661,P=0.001,约登指数0.203对应的临界值取整数为4分,敏感度和特异度分别为72.6%和47.7%,提示SAMe-TT 2R 2对预测TTR<65%有一定的价值。随访期间共有5例患者发生缺血性卒中事件,25例患者发生不同程度出血事件,11例患者发生全因死亡事件,上述事件在各个SAMe-TT 2R 2分值的发生分布差异无统计学意义(P>0.05)。结论在非瓣膜性房颤并使用华法林抗凝治疗的患者中,SAMe-TT 2R 2评分对使用华法林抗凝治疗患者的抗凝有效性具有一定的预测能力,可将SAMe-TT 2R 2评分作为预测华法林抗凝疗效的预测的指标。
Objective To evaluate the anticoagulant effect of SAMe-TT 2R 2 in patients with non-valvular atrial fibrillation treated with warfarin,and to explore the correlation between SAMe-TT 2R 2 and ischemic stroke events and bleeding events.Methods Patients who were diagnosed as non-valvular atrial fibrillation and with oral warfarin were enrolled in the First Affiliated Hospital of Shihezi University School of Medical College in January 2018-January 2019,and for 10 months of follow-up.Collecting patients'International normalization ratio(INR),calculating the Time in therapeutic range(TTR),and the SAMe-TT2 R2 score.Andχ2 test,Spearman rank correlation and ROC curve analysis were used to evaluate the predictive ability of SAMe-TT2 R2 score on anticoagulant efficacy in patients.Follow-up was conducted to investigate the incidence of ischemic stroke or hemorrhagic events and explore the relationship with the SAMe-TT2 R2 score.Results The mean TTR of 190 patients was 46.76%±21.99%,and the score of SAMe-TT 2 R2 was negatively correlated with the TTR of the patients(P=0.001),the area under the ROC curve was 0.661,P=0.001,The critical value corresponding was 4 points,and the sensitivity and specificity were 72.6%and 47.7%,respectively suggesting that SAMe-TT 2R 2 had certain value in predicting TTR<65%.During follow-up,a total of 5 patients had ischemic stroke,25 patients had different degrees of bleeding,and 11 patients had all-cause death,different SAMe-TT 2R 2 scores showed no statistical significance(P>0.05).Conclusion In patients with non-valvular atrial fibrillation treated with warfarin anticoagulant,the SAMe-TT 2R 2 score has a certain predictive ability for the anticoagulant efficacy of patients treated with warfarin anticoagulant,and the SAMe-TT 2R 2 score could be used as an indicator for predicting the anticoagulant efficacy of warfarin.
作者
杨诗琪
王丽
李岳明
王楠
YANG Shiqi;WANG Li;LI Yueming;WANG Nan(Department of Cardiology,The First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832000,China)
出处
《广州医药》
2020年第2期31-35,共5页
Guangzhou Medical Journal
基金
院级重点领域创新团队项目(TJ2016-001)。
