彭飞飞 蒋亚萍

    [摘要]?目的?探討抗活化因子Ⅹ活性试验(anti-FⅩ?activity?assay，anti-FⅩa)对服用利伐沙班抗凝的非瓣膜性心房颤动(non-valvular?atrial?fibrillation，NVAF)患者出血事件的预测价值。方法?选取2020年1月至2022年1月台州市第一人民医院收治的190例服用利伐沙班抗凝的NVAF患者，根据患者年龄将其分为75岁组(98例)。以发色底物法进行anti-FⅩa检测，测定利伐沙班的血药浓度。采用受试者操作特征曲线(receiver?operating?characteristic?curve，ROC曲线)分析anti-FⅩa对出血事件的预测效能，采用Kaplan-Meier法进行生存分析。结果?随着年龄的增加，患者利伐沙班峰值和谷值浓度及出血事件发生率均逐渐升高(P75岁组患者出血事件预测的临界值分别为186.43ng/ml、201.18ng/ml和212.63ng/ml时，敏感度分别为81.62%、81.82%和91.89%；谷值浓度的预测临界值分别为34.36ng/ml、36.72ng/ml和38.42ng/ml时，敏感度分别为83.67%、90.91%和94.59%，但特异性均较低。以38.42ng/ml为谷值浓度的临界值，随访90d时谷值浓度高于临界值的患者出血事件风险大于低于临界值的患者，且出血事件随时间延长呈加重趋势(P

    [Abstract]?Objective?To?investigate?the?predictive?value?of?anti-FⅩ?activity?assay?(anti-FⅩa)?for?bleeding?events?in?patients?with?non-valvular?atrial?fibrillation?(NVAF)?taking?rivaroxaban?anticoagulation.?Methods?A?total?of?190?NVAF?patients?taking?rivaroxaban?anticoagulant?treated?in?Taizhou?First?Peoples?Hospital?from?January?2020?to?January?2022?were?selected?and?divided?into?75?years?old?group?(98?cases)?according?to?their?age.?The?serum?concentration?of?rivaroxaban?was?determined?by?anti-FⅩa?assay?using?chromogenic?substrate?method.?The?predictive?efficacy?of?anti-FⅩa?on?bleeding?events?was?analyzed?by?receiver?operating?characteristic?(ROC)?curve ......