口服华法林老年心房颤动患者认知障碍的影响因素  

Influencing factors of cognitive disorder in elderly patients with atrial fibrillation who take oral Warfarin

作　　者：边树伟[1] 周志安[1] BIAN Shuwei;ZHOU Zhian(Department of General Medicine,Chengde Central Hospital,Hebei Province,Chengde067000,China)

机构地区：[1]河北省承德市中心医院全科医学科,河北承德067000

出　　处：《中国医药导报》2023年第29期51-55,共5页China Medical Herald

基　　金：河北省医学科学研究课题计划项目(20191300)。

摘　　要：目的探讨口服华法林心房颤动(AF)老年患者认知障碍(CD)的影响因素。方法采用横断面调查,选取自2019年2月至2022年2月在河北省承德市中心医院住院的AF患者121例,应用认知障碍评定量表(CDR)将患者分为无CD组(59例)和CD组(62例)。收集其用药情况、疾病史、人口学资料。采用logistic回归分析认知障碍的影响因素,绘制受试者工作特征(ROC)曲线,评估口服华法林对CD的预测价值。结果不同CD患者华法林抗凝稳定性、高血压病、糖尿病、左室射血分数(LVEF)比例比较,差异有统计学差异(P<0.05)。logistic回归分析结果显示,高血压病[OR(95%CI)=3.003(1.184,7.617)]、糖尿病[OR(95%CI)=4.347(1.756,10.759)]、华法林抗凝[OR(95%CI)=3.915(1.572,9.750)]、LVEF[OR(95%CI)=0.893(0.826,0.966)]是老年AF患者CD的影响因素(P<0.05)。华法林抗凝治疗稳定预测CD的曲线下面积[AUC(95%CI)]为0.802(0.725~0.879),取约登指数最大值0.466时,所对应的灵敏度为83.9%,特异度为62.7%。结论糖尿病、高血压病、华法林抗凝治疗稳定性,LVEF是AF患者CD的影响因素,华法林抗凝治疗稳定对AF患者的CD具有较好的预测价值。Objective To investigate the influencing factors of cognitive disorder(CD)in elderly patients with oral Warfarin atrial fibrillation(AF).Methods A total of 121 patients with atrial fibrillation admitted to Chengde Central Hospital,Hebei Province from February 2019 to February 2022 were selected in a cross-sectional survey.The patients were divided into group without CD(59 cases)and group with CD(62 cases)by using the cognitive disorder rating scale(CDR).The drug use,medical history,and demographic data were collected.Logistic regression analysis was used to analyze the influencing factors of cognitive impairment,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of oral Warfarin in CD.Results There were significant differences in Warfarin anticoagulant stability,hypertension,diabetes,and left ventricular ejection fraction(LVEF)among patients with different CD patients(P<0.05).Logistic regression analysis showed that hypertension(OR[95%CI]=3.003[1.184,7.617]),diabetes(OR[95%CI]=4.347[1.756,10.759]),Warfarin anticoagulation(OR[95%CI]=3.915[1.572,9.750]),and LVEF(OR[95%CI]=0.893[0.826,0.966])were the influencing factors for CD in elderly patients with AF(P<0.05).The area under the curve(AUC[95%CI])of Warfarin anticoagulant treatment was 0.802(0.725-0.879),and the sensitivity and specificity of CD were 83.9%and 62.7%when the maximum Jorden index was 0.466.Conclusion Diabetes,hypertension,warfarin anticoagulant treatment stability,LVEF are influencing factors for CD in patients with AF,Warfarin anticoagulant treatment stability has a good predictive value for CD in patients with AF.

关 键 词：心房颤动 认知障碍 华法林 

分 类 号：R541.75[医药卫生—心血管疾病]