广州医药 ›› 2020, Vol. 51 ›› Issue (2): 31-35.DOI: 10.3969/j.issn.1000-8535.2020.02.007

• 论著 • 上一篇    下一篇

SAMe-TT2R2评分在非瓣膜性房颤患者抗凝疗效中的评估

杨诗琪, 王丽, 李岳明, 王楠   

  1. 新疆石河子大学医学院第一附属医院心内三科(石河子 832000)
  • 收稿日期:2019-11-25 出版日期:2020-03-20 发布日期:2021-11-28
  • 通讯作者: 王丽,E-mail:183304153@qq.com
  • 基金资助:
    院级重点领域创新团队项目(TJ2016-001)

Evaluation of SAMe-TT2R2 score in the anticoagulation effect of patients with non-valvular atrial fibrillation

YANG Shiqi, WANG Li, LI Yueming, WANG Nan   

  1. Department of Cardiology,The First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi 832000,China
  • Received:2019-11-25 Online:2020-03-20 Published:2021-11-28

摘要: 目的 评价SAMe-TT2R2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-TT2R2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-TT2R2评分。运用χ2检验、Spearman秩相关、ROC曲线分析评估SAMe-TT2R2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-TT2R2评分的相关性。结果 190例患者平均TTR为(46.76±21.99)%,SAMe-TT2R2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-TT2R2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-TT2R2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-TT2R2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-TT2R2评分作为预测华法林抗凝疗效的预测的指标。

关键词: 非瓣膜性房颤, 华法林, SAMe-TT2 R2评分, 抗凝疗效评估

Abstract: Objective To evaluate the anticoagulant effect of SAMe-TT2R2 in patients with non-valvular atrial fibrillation treated with warfarin, and to explore the correlation between SAMe-TT2R2 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. And χ2 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-TT2 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-TT2R2 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-TT2R2 scores showed no statistical significance(P>0.05). Conclusion In patients with non-valvular atrial fibrillation treated with warfarin anticoagulant, the SAMe-TT2R2 score has a certain predictive ability for the anticoagulant efficacy of patients treated with warfarin anticoagulant, and the SAMe-TT2R2 score could be used as an indicator for predicting the anticoagulant efficacy of warfarin.

Key words: Non-valvular atrial fibrillation, Warfarin, SAMe-TT2R2 score, Evaluation of anticoagulant efficacy