作者：柳万千，罗潇，陈玲，何华斌，袁明清

单位：

332000江西省九江市第一人民医院心血管内科

单位（英文）：

Department of Cardiology, Jiu Jiang NO.1 People's Hospital, Jiujiang 332000, China

关键词：

心房颤动；SAMe-TT2R2积分；CHA2DS2-VASc-60卒中评分；治疗目标范围内的时间百分比；预测

关键词（英文）：

Atrial fibrillation; SAMe-TT2R2 score; CHA2DS2-VASc-60 stroke score; Time within therapeutic range; Forecasting

中图分类号：

R 541.75

DOI：

10.12114/j.issn.1008-5971.2024.00.008

基金项目：

江西省卫生健康委科技计划项目（202211818）

摘要：

目的　分析SAMe-TT 2R2积分与CHA2 DS2-VASc-60 卒中评分对持续性非瓣膜性心房颤动患者治疗目 标范围内的时间百分比（TTR）未达标的预测价值。 方法　 回顾性选取 2020—2022年就诊于九江市第一人民医院的 持续性非瓣膜性心房颤动患者107例为研究对象。收集患者的一般资料、SAMe-TT2R2积分、CHA2DS2-VASc-60卒 中评分。根据TTR达标情况将患者分为TTR达标组（32例）和TTR未达标组（75例）。两变量间的相关性分析采用 Pearson相关分析；采用ROC曲线分析SAMe-TT2R2积分与CHA2DS2-VASc-60卒中评分对持续性非瓣膜性心房颤动患者 TTR未达标的预测价值。结果　TTR达标组年龄≥60岁者占比、SAMe-TT2R2积分低于TTR未达标组，吸烟者占比、 CHA2DS2-VASc-60卒中评分高于TTR未达标组（P＜0.05）。Pearson相关分析结果显示，持续性非瓣膜性心房颤动患 者SAMe-TT 2R 2积分与 TTR呈正相关（r=0.766 ，P ＜ 0.001 ）， CHA 2DS 2-VASc-60 卒中评分与TTR呈负相关（r=－0.622， P＜0.001）。 ROC 曲线分析结果显示， SAMe-TT 2 R2 积分与 CHA 2DS 2-VASc-60 卒中评分预测持续性非瓣膜性心房颤动患 者TTR未达标的AUC分别为0.821〔95%CI（0.733～0.909）〕、0.939〔95%CI（0.896～0.982）〕，最佳截断值分别为 5.5、2.5分，灵敏度分别为0.719、0.813，特异度分别为0.813、0.933。结论　SAMe-TT2R2积分对持续性非瓣膜性心房 颤动患者TTR未达标具有一定预测价值，而CHA2DS2-VASc-60卒中评分对其具有较高预测价值。

英文摘要：

Objective To analyze the predictive value of SAMe-TT 2R2 score and CHA2DS2-VASc-60 stroke score for time within therapeutic range (TTR) non-compliance in patients with persistent non valvular atrial fibrillation. Methods A total of 107 patients with persistent non valvular atrial fibrillation admitted to Jiu Jiang NO.1 People's Hospital from 2020 to 2022 were retrospectively selected as the study objects. General data, SAMe-TT2R2 score and CHA2DS2-VASc-60 stroke score of the patients were collected. According to TTR compliance, the patients were divided into TTR compliance group (32 cases) and TTR non-compliance group (75 cases) . Pearson correlation analysis was used to analyze the correlation between two variables. ROC curve was used to analyze the predictive value of SAMe-TT2R2 score and CHA 2DS2-VASc-60 stroke score for TTR non compliance in patients with persistent non valvular atrial fibrillation. Results The proportion of patients aged ≥ 60 years and SAMe-TT2R2 score in TTR compliance group were lower than those in TTR non-compliance group, and the proportion of smokers and CHA2DS2-VASc-60 stroke score were higher than those in TTR non-compliance group (P < 0.05) . Pearson correlation analysis results showed that the SAMe-TT2R2 score was positively correlated with TTR in patients with persistent non valvular atrial fibrillation (r=0.766, P < 0.001) , while the CHA2DS2-VASc-60 stroke score was negatively correlated with TTR (r= －0.622, P < 0.001) . ROC curve analysis results showed that the AUC of SAMe-TT2R2 score and CHA2DS2-VASc-60 stroke score in predicting TTR non-compliance in patients with persistent non valvular atrial fibrillation was 0.821 [95%CI (0.733-0.909) ] and 0.939 [95%CI (0.896-0.982) ] , respectively. The optimal cut-off values were 5.5 and 2.5 points, the sensitivity was 0.719 and 0.813, and the specificity was 0.813 and 0.933, respectively. Conclusion SAMe-TT2R2 score has certain predictive value for TTR non-compliance in patients with persistent non valvular atrial fibrillation, while the CHA2DS2-VASc-60 stroke score has higher predictive value.

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