观察ROC曲线用于评估非瓣膜心房颤动患者华法林抗凝出血风险  

Investigation of ROC curve to assess the risk of bleeding in non-valvular atrial fibrillation patients treated with warfarin

作　　者：王宽[1] 王东[1] 郑柳颖[1] 左国兴 张明惠[1] 杜新平[1] 

机构地区：[1]天津市第五中心医院心内科,天津300450

出　　处：《中国临床药理学杂志》2013年第5期323-325,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察非瓣膜心房颤动(NVAF)患者华法林抗凝出血风险。方法回顾性分析2008年1月至2012年6月我科收治的口服华法林抗凝治疗NVAF患者177例,其中抗凝治疗过程中发生出血事件者56例(出血组);未出现出血事件者121(非出血组)。比较2组患者华法林用量、国际标准化比值(INR)有无差别。结果 2组患者华法林用量差别无统计学意义(P=0.40);出血组INR显著高于非出血组(P<0.01);2组患者INR与华法林用量间不存在明显相关性(P=0.062);INR判断出血风险的敏感性为75.4%,特异性为80.2%。结论INR可作为评估出血风险的重要指标,随INR增大患者出血风险明显增加。Objective To assess the risk of bleeding in non - valvular atrial fibrillation （NVAF）patients treated with warfarin. Methods One hundred and seventy - seven patients with non - valvular atrial fibrillation treated with warfarin were evaluated from tively. Of the 177 patients, 55 cases had Jan 2008 to Jun 2012 respecbleeding history was considered as case group, and 121 subjects had non- bleeding history were considered as control group. The International Normalized Ratio （INR）and warfarin dose were recorded and compared the difference between the two groups. Results There was no statistical difference of warfarin dose between the two groups （P = 0. 40）. But the INR in bleeding group was much higher than that in control group （ P 〈 0.01 ）. And no association between warfarin dose and INR was observed in this study （P = 0. 062）. The sensitivity and specificity to distinguish bleeding were 75.4% and 80.2% respectively by using INR. Condusion INR was an important clinical indicator for predicating bleeding in patien rin, and significantly increased risk of bleeding in ts treated with warfa- patients with INR increases.

关 键 词：非瓣膜心房颤动 华法林 ROC曲线 

分 类 号：R973.2[医药卫生—药品] R541.75[医药卫生—药学]