作　　者： ; ; ; ;

机构地区： 潮州市中心医院

出　　处： 《河北医学》 2020年第4期644-649,共6页

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。 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 hig

关 键 词： 冠心病 凝血酶原时间 房颤 血栓栓塞 心血管事件

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