摘要
目的分析红细胞体积分布宽度(RDW)和脂蛋白a〔Lp(a)〕与持续性心房颤动患者华法林抗凝治疗稳定性的关系。方法选取2022年在江西省人民医院就诊的持续性心房颤动患者118例为研究对象。收集患者一般资料,根据华法林抗凝治疗稳定性将患者分为稳定组〔治疗目标范围内的时间百分比(TTR)达标,52例〕和不稳定组(TTR未达标,66例)。采用二元Logistic回归分析探讨持续性心房颤动患者华法林抗凝治疗稳定性的影响因素;绘制ROC曲线以评估RDW、Lp(a)及其联合对持续性心房颤动患者华法林抗凝治疗不稳定的预测价值。结果不稳定组红细胞计数(RBC)、血红蛋白(Hb)低于稳定组,血小板体积分布宽度(PDW)、RDW、Lp(a)高于稳定组,左心房内径(LAD)小于稳定组(P<0.05)。二元Logistic回归分析结果显示,RDW、Lp(a)是持续性心房颤动患者华法林抗凝治疗不稳定的影响因素(P<0.05)。ROC曲线分析结果显示,RDW、Lp(a)预测持续性心房颤动患者华法林抗凝治疗不稳定的AUC分别为0.654〔95%CI(0.611~0.798)〕、0.704〔95%CI(0.555~0.752)〕,最佳截断值分别为13.65%、16.35 mg/L,灵敏度分别为0.561、0.470,特异度分别为0.712、0.942;RDW联合Lp(a)预测持续性心房颤动患者华法林抗凝治疗不稳定的AUC为0.740〔95%CI(0.652~0.829)〕。结论RDW、Lp(a)是持续性心房颤动患者华法林抗凝治疗不稳定的影响因素,且RDW联合Lp(a)对持续性心房颤动患者华法林抗凝治疗不稳定有一定预测价值。
Objective To explore the relationship between red cell volume distribution width(RDW)and lipoprotein a[Lp(a)]and the stability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation.Methods A total of 118 patients with persistent atrial fibrillation admitted to Jiangxi Provincial People's Hospital in 2022 were selected as the study subjects.General information of patients was collected and the patients were divided into the stable group[time within therapeutic range(TTR)meet the standard,52 cases]and the unstable group(TTR did not meet the standard,66 cases)according to the stability of warfarin anticoagulant therapy.Binary Logistic regression analysis was used to explore the influencing factors of the stability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation;ROC curve was drawn to evaluate the predictive value of RDW,Lp(a),and their combination for the instability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation.Results The red blood cell(RBC),and hemoglobin(Hb)in the unstable group were lower than those in the stable group,platelet volume distribution width(PDW),RDW,and Lp(a)were higher than those in the stable group,and left atrial diameter(LAD)was smaller than that in the stable group(P<0.05).The results of binary Logistic regression analysis showed that RDW and Lp(a)were the influencing factors of the instability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation(P<0.05).ROC curve analysis results showed that the AUC of RDW and Lp(a)in predicting the instability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation was 0.654[95%CI(0.611-0.798)]and 0.704[95%CI(0.555-0.752)],the optimal cutoff values were 13.65% and 16.35 mg/L,the sensitivity was 0.561 and 0.470,and the specificity was 0.712 and 0.942,respectively;the AUC of RDW combined with Lp(a)in predicting the instability of warfarin anticoagulant therapy in patients with persistent atrial fibrillation wa
作者
黄海龙
罗潇
刘松涛
HUANG Hailong;LUO Xiao;LIU Songtao(Department of Cardiovascular Medicine,Poyang Gongyeyuanqu Hospital,Shangrao 333100,China;Department of Cardiovascular Medicine,Jiu Jiang NO.1 People's Hospital,Jiujiang 332000,China;Department of Cardiovascular Medicine,Jiangxi Provincial People's Hospital,Nanchang 330000,China)
出处
《实用心脑肺血管病杂志》
2024年第12期44-48,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
2022年度江西省卫生健康委科技计划项目(202211818)。
关键词
心房颤动
红细胞体积分布宽度
脂蛋白A
华法林
抗凝治疗
Atrial fibrillation
Red cell volume distribution width
Lipoprotein a
Warfarin
Anticoagulant therapy
