您的位置: 首页 > 2020年3月 第51卷 第2期 > 文字全文
2023年7月 第38卷 第7期11
目录

SAMe-TT2R2评分在非瓣膜性房颤患者抗凝疗效中的评估

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

来源期刊: 广州医药 | 31-35 发布时间:2021-11-28 收稿时间:2025/11/13 17:52:46 阅读量:14
作者:
关键词:
非瓣膜性房颤华法林SAMe-TT2 R2评分抗凝疗效评估
Non-valvular atrial fibrillationWarfarinSAMe-TT2R2 score" style="padding-right:10px">2R2 score')">SAMe-TT2R2 scoreEvaluation of anticoagulant efficacy
DOI:
10.3969/j.issn.1000-8535.2020.02.007
收稿时间:
2019-11-25 
修订日期:
 
接收日期:
 
引用总数:
0  
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。
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.
1、 伍珊珊. 房颤患者服用华法林抗凝质量及其与SAMe-TT2 R2评分的关系[D]. 南方医科大学, 2019. 伍珊珊. 房颤患者服用华法林抗凝质量及其与SAMe-TT2 R2评分的关系[D]. 南方医科大学, 2019.
2、 ROLDAN V, CANCIO S, GALVEZ J, et al. The SAMe-TT2R2 score predicts poor anticoagulation control in af patients: a prospective “real-world” inception cohort study[J]. Am J Med, 2015, 128(11): 1237-1243. ROLDAN V, CANCIO S, GALVEZ J, et al. The SAMe-TT2R2 score predicts poor anticoagulation control in af patients: a prospective “real-world” inception cohort study[J]. Am J Med, 2015, 128(11): 1237-1243.
3、 陈文文, 党和勤, 耿涛,等. SAMe-TT2R2评分对非瓣膜性华法林抗凝控制质量的预测能力评价[J]. 中国医院药学杂志, 2017, 37(20): 2072-2076. 陈文文, 党和勤, 耿涛,等. SAMe-TT2R2评分对非瓣膜性华法林抗凝控制质量的预测能力评价[J]. 中国医院药学杂志, 2017, 37(20): 2072-2076.
4、 APOSTOLAKIS S, SULLIVAN R M, OLSHANSKY B, et al. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT(2)R(2) score[J]. Chest, 2013, 144(5): 1555-1563. APOSTOLAKIS S, SULLIVAN R M, OLSHANSKY B, et al. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT(2)R(2) score[J]. Chest, 2013, 144(5): 1555-1563.
5、 VEEGER N J, PIERSMA-WICHERS M, TIJSSEN J G, et al. Individual time within target range in patients treated with vitamin K antagonists: main determinant of quality of anticoagulation and predictor of clinical outcome. a retrospective study of 2 300 consecutive patients with venous thromboembolism[J]. Br J Haematol, 2005, 128(4): 513-519. VEEGER N J, PIERSMA-WICHERS M, TIJSSEN J G, et al. Individual time within target range in patients treated with vitamin K antagonists: main determinant of quality of anticoagulation and predictor of clinical outcome. a retrospective study of 2 300 consecutive patients with venous thromboembolism[J]. Br J Haematol, 2005, 128(4): 513-519.
6、 CONNOLLY S J, POGUE J, EIKELBOOM J, et al. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range[J]. Circulation, 2008, 118(20): 2029-2037. CONNOLLY S J, POGUE J, EIKELBOOM J, et al. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range[J]. Circulation, 2008, 118(20): 2029-2037.
7、 JONES M, MCEWAN P, MORGAN C L, et al. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population[J]. Heart, 2005, 91(4): 472-477. JONES M, MCEWAN P, MORGAN C L, et al. Evaluation of the pattern of treatment, level of anticoagulation control, and outcome of treatment with warfarin in patients with non-valvar atrial fibrillation: a record linkage study in a large British population[J]. Heart, 2005, 91(4): 472-477.
8、 中华医学会心血管病学分会, 中国老年学学会心脑血管病专业委员会. 华法林抗凝治疗的中国专家共识[J]. 中华内科杂志, 2013, 52(1): 76-82. 中华医学会心血管病学分会, 中国老年学学会心脑血管病专业委员会. 华法林抗凝治疗的中国专家共识[J]. 中华内科杂志, 2013, 52(1): 76-82.
上一篇
下一篇
出版者信息








《广州医药》公众号
目录