AST/ALT比值联合APTT对利伐沙班治疗老年非瓣膜性房颤患者的预后价值  

Prognostic value of AST/ALT ratio combined with APTT regimen in NVAF patients receiving rivaroxaban anticoagulant therapy

作　　者：陈毅 宁萌[2] 刘迎午 Chen Yi;Ning Meng;Liu Yingwu(The Third Central Clinical College of Tianjin Medical University,Tianjin 300170,China;The Third Central Hospital of Tianjin,Tianjin 300170,China)

机构地区：[1]天津医科大学三中心临床学院,天津300170 [2]天津市第三中心医院,天津300170

出　　处：《国际生物医学工程杂志》2023年第2期138-143,共6页International Journal of Biomedical Engineering

基　　金：天津市卫生健康科技项目(ZC20226)。

摘　　要：目的探讨天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)比值联合活化部分凝血活酶时间(APTT)对利伐沙班治疗老年非瓣膜性房颤(NVAF)患者的预后价值。方法选取2020年6月至2021年6月天津市第三中心医院122例应用利伐沙班抗凝的老年NVAF患者,依据中位数法将患者分为4组,即Q1组(32例):低AST/ALT/低APTT;Q2组(27例):低AST/ALT/高APTT;Q3组(29例):高AST/ALT/低APTT;Q4组(34例):高AST/ALT/高APTT,对4组患者的有效性终点事件和安全性终点事件进行分析,并对复合终点事件进行单因素和多因素Cox回归分析。结果Q1~Q4组的有效性终点事件分别为0例(0)、1例(3.70%)、4例(13.79%)、5例(14.71%),主要为心血管死亡;安全性终点事件分别为5例(15.62%)、2例(7.41%)、6例(20.69%)、5例(14.71%),主要为非主要出血事件。与Q1组相比,在纳入传统危险因素校正后Q4组的复合终点事件风险增加(HR:3.851,95%CI:1.167~12.704)。结论AST/ALT比值联合APTT可对利伐沙班抗凝治疗的老年NVAF患者远期出血和心血管不良事件进行危险分层,对其预后有一定的预测价值。Objective To investigate the prognostic value of the ratio of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)combined with activated partial thromboplastin time(APTT)in elderly patients with non-valvular atrial fibrillation(NVAF)treated with rivaroxaban.Methods One hundred and twenty-two elderly patients with NVAF who were anticoagulated with rivaroxaban from June 2020 to June 2021 in the Third Central Hospital of Tianjin were enrolled and divided into four groups based on the median method.The patients in the Q1 group(n=32)have low AST/ALT/low APTT.The patients in the Q2 group(n=27)have low AST/ALT/high APTT.The patients in the Q3 group(n=29)have high AST/ALT/low APTT.The patients in the Q4 group(n=34)have high AST/ALT/high APTT.The efficacy endpoint events,and safety endpoint events were analyzed in the four groups,and univariate and multivariate Cox regression analyses were performed for the composite endpoint events.Results The effectiveness endpoint events were mainly cardiovascular deaths,the number of which in the Q1 to Q4 groups was 0(0),1(3.70%),4(13.79%),and 5(14.71%),respectively.The safety endpoint events were mainly non-major bleeding events,the number of which in the Q1 to Q4 groups was 5(15.62%),2(7.41%),6(20.69%),and 5(14.71%),respectively.Compared to the Q1 group,the Q4 group had an increased risk of composite endpoint events after incorporating traditional risk factor correction(HR:3.851,95%CI:1.167 to 12.704).Conclusions AST/ALT ratio combined with APTT can provide risk stratification for distant bleeding and cardiovascular adverse events in elderly NVAF patients treated with rivaroxaban anticoagulation and has some predictive value for their prognosis.

关 键 词：利伐沙班 非瓣膜性房颤 天冬氨酸转氨酶 丙氨酸转氨酶 活化部分凝血活酶时间 

分 类 号：R541.75[医药卫生—心血管疾病]