不同INR对冠心病合并房颤患者血栓栓塞事件以及主要不良心血管事件的影响

doi:10.3969/j.issn.1006-6233.2020.04.027

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摘要 目的:探讨不同血浆凝血酶原时间国际标准化比值(INR)对冠心病合并房颤患者血栓栓塞事件与不良心血管事件的影响。方法:选取2013年12月至2018年10月发生血栓栓塞事件与心血管不良事件的冠心病合并房颤患者120例作为观察组,另选110例未发生血栓栓塞事件与不良心血管事件的冠心病合并房颤患者为对照组,观察两组患者一般资料采用单因素与多因素Logistic回归分析导致患者发生血栓栓塞事件与不良心血管事件的危险因素,对观察组INR值表达分布情况进行观察;采用ROC曲线分析INR对冠心病合并房颤患者发生血栓栓塞与不良心血管事件的预测价值。结果:单因素与多因素Logistic回归分析显示:INR、年龄、左心房增大≥40mm、左心室射血分数<50%、高血压、慢性肾病、心功能分级为导致冠心病合并AF患者发生心血管不良事件与血栓栓塞事件的影响因素与独立危险因素,差异具有统计学意义(P<0.05)。观察组INR值<1.5有6例(5.00%)、1.5~1.99有4例(3.33%)、2.0~2.49有20例(16.67%)、≥2.5有90例(75.00%)。INR对冠心病合并房颤患者发生血栓栓塞与不良心血管事件的预测敏感度为77.5%、特异度100.0%、AUC为0.915、最佳临界值为2.35。结论:冠心病合并房颤患者其INR属于导致其发生血栓栓塞与不良心血管事件的独立危险因素,对预测血栓栓塞与不良心血管事件具有一定价值,如INR较高发生血栓栓塞与不良心血管事件概率就越高。

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关键词 ：冠心病, 凝血酶原时间, 房颤, 血栓栓塞, 心血管事件

Abstract：Objective: To study the effect of INR on thromboembolic events and adverse cardiovascular events in patients with coronary heart disease and atrial fibrillation. Methods: From December 2013 to October 2018, 120 patients with coronary heart disease and atrial fibrillation who had thromboembolic events and adverse cardiovascular events were selected as the observation group, and 110 patients with coronary heart disease and atrial fibrillation who did not have thromboembolic events and adverse cardiovascular events were selected as the control group. The risk factors of thromboembolism and adverse cardiovascular events were analyzed by single factor and multi factor Logistic regression, and the distribution of INR value in the observation group was observed; the predictive value of INR for thromboembolism and adverse cardiovascular events in patients with coronary heart disease and atrial fibrillation was analyzed by ROC curve. Results: Univariate and multivariate Logistic regression analysis showed that the age of INR, left atrial enlargement ≥ 40mm, left ventricular ejection fraction < 50%, hypertension and chronic kidney disease cardiac function grade were the influencing factors and independent risk factors of cardiovascular adverse events and thrombus embolism events in patients with coronary heart disease complicated with AF (P<0.05).There were 6 cases (5.00%) with INR value < 1.5, 4 cases (3.33%) with INR value of 1.5-1.99, 20 cases (16.67%) with INR value of 2.0-2.49,90 cases (75.00%) with INR value ≥ 2.5 in the observation group. The sensitivity and specificity of INR in predicting thrombus embolism and adverse cardiovascular events in patients with coronary heart disease complicated with atrial fibrillation were 77.5%, 100.0%, 0.915 and 2.35 respectively. Conclusion: INR in patients with coronary heart disease complicated with atrial fibrillation is an independent risk factor for thrombus embolism and adverse cardiovascular events, which has certain value in predicting thrombus embolism and adverse cardiovascular events. For example, the higher the probability of thrombus embolism and adverse cardiovascular events in patients with coronary heart disease complicated with atrial fibrillation, the higher the probability of thrombus embolism and adverse cardiovascular events.

Key words： Coronary heart disease Prothrombin time Atrial fibrillation Thrombus embolism Cardiovascular events

基金资助:广东省潮州市科技计划项目,(编号:20170603)

引用本文:

许贤彬, 卢旭升, 陈尔周, 林旭城, 李春来. 不同INR对冠心病合并房颤患者血栓栓塞事件以及主要不良心血管事件的影响[J]. 河北医学, 2020, 26(4): 644-649.
XU Xianbin, LU Xusheng, CHEN Erzhou, et al. Effects of Different INR on Thromboembolic Events and Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease Complicated with Atrial Fibrillation. HeBei Med, 2020, 26(4): 644-649.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.04.027 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I4/644

[1] 罗羽慧,崔坤,梅霞.高龄冠心病合并房颤患者不同抗栓治疗方案的疗效及安全性研究[J].重庆医学,2017,46(5):607~608.
[2] Numao Y, Suzuki S, Arita T, et al. Predictors of international normalized ratio variability in patients with atrial fibrillation under warfarin therapy[J]. Circulation Journal, 2017, 82(1):39~45.
[3] Camm AJ,Kirchhof P,Lip GY,et al.ESC committee for practice guidelines.guidelines for the management of atrial fibrillation:the task force for the management of atrial fibrillation of the european society of cardiology( ESC )[J].Europace,2010,12(10):1360~1420.
[4] Batchelor R, Kumar R, Gilmartin-Thomas J F M, et al. Systematic review with meta-analysis: risk of adverse cardiovascular events with proton pump inhibitors independent of clopidogrel[J]. Alimentary Pharmacology & Therapeutics, 2018, 48(8):780~796.
[5] Wandelt L K, Kowallick J T, Schuster A, et al. Quantification of left atrial volume and phasic function using cardiovascular magnetic resonance imaging-comparison of biplane area-length method and Simpson's method[J]. International Journal of Cardiovascular Imaging, 2017, 33(12):1~9.
[6] 李文安,刘凯,江帆,等.稳定型冠心病患者低血清白蛋白浓度与不良心血管事件相关性探讨[J].心肺血管病杂志,2017,36(11):888~892.
[7] 刘红琼,刘代国.老年高血压患者脉压及脉压指数与冠心病相关性研究[J].北华大学学报(自然科学版),2018,19(06):81~84.
[8] 王雪荣,王德光,张晶晶,等.慢性肾脏病患者血镁与心血管事件相关性分析[J].安徽医科大学学报,2017,52(2):288~292.
[9] 王艳.控制不同INR对老年稳定性冠心病合并房颤患者的临床观察[J].航空航天医学杂志,2018,29(3):317~319.
[10] 张冬梅,张后民.控制不同INR对老年稳定性冠心病合并房颤患者的临床观察[J].重庆医学,2017,46(24):3420~3421.