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The Internal and External Factors That Help to Push English into a Popular World Language
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作者 顾欢欢 《英语广场(学术研究)》 2012年第1期64-64,59,共2页
It is well known that English is the world language nowadays, and it is an official language in most countries. It is also currently the language most often taught as a foreign language. The reasons of the popularity ... It is well known that English is the world language nowadays, and it is an official language in most countries. It is also currently the language most often taught as a foreign language. The reasons of the popularity lie in both internal factors and external factors. In this paper, the author will analyze the factors that help to push English into a popular world language. 展开更多
关键词 world language official language internal factors external factors
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Exploring the Internal and External Factors that Influence Chinese EFL Students' Speaking Performance: A Case Study
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作者 陈思 《海外英语》 2017年第19期238-240,共3页
This case study on one Chinese EFL learner examined both the internal and external factors that affect Chinese EFL learner's speaking performance. Three interviews and three tests have been conducted in the whole ... This case study on one Chinese EFL learner examined both the internal and external factors that affect Chinese EFL learner's speaking performance. Three interviews and three tests have been conducted in the whole process, and the findings revealed:(1) interference from first language is the most influential factor that hinders speaking performance;(2) learner attitude significantly affects speaking performance;(3) learning strategies and practicing help improving performance. 展开更多
关键词 internal factors external factors EFL students speaking performance
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The Internal and External Factors That Help to Push English into a Popular World Language
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作者 廖春玫 《海外英语》 2013年第24期221-223,共3页
At the present times, English is an important language tool for communication in the international affairs. More than two hundred years ago, to foresee the international economic and cultural life in the future, moder... At the present times, English is an important language tool for communication in the international affairs. More than two hundred years ago, to foresee the international economic and cultural life in the future, modern German philosopher Leibniz have insightfully pointed out that mutual exchanges among the countries need a universal language for communication. The Unit?ed States and Britain, on the other hand, have the dominant position in international affairs, which makes English become a domi?nant language in the world. This paper tries to figure out the internal and external factors that help to push English into a popular world language basing on the process of the English language's development. 展开更多
关键词 internal factors external factors world LANGUAGE
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Empirical Analysis on Factors Affecting Mobile Internet Users’ Purchase Intention for 3G Handsets 被引量:1
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作者 宁连举 夏文 《China Communications》 SCIE CSCD 2011年第7期144-152,共9页
The research on consumers' purchase intention for 3G handsets has important theoretical and practical value. This research puts forward four key factors which influence consumers' purchase intention based on t... The research on consumers' purchase intention for 3G handsets has important theoretical and practical value. This research puts forward four key factors which influence consumers' purchase intention based on the cue utilization theory, situational theory and social impact theory, then it establishes the study model for consumers' purchase intention of 3G handsets. Based on the result of the questionnaire survey and empirical analysis, the study shows that social influence is the most prominent factor in purchase intention. Moreover, as different from results of previous studies, the situational influence factors have no significant impact on purchase intention in the 3G handsets market. The results of the model provides a forceful evidence for operators' and handset manufacturers' decision-making of 3G handsets design and marketing strategies, and it will improve their social impact. 展开更多
关键词 purchase intention 3G handset internal (external) cues situational influence factors social influence factors
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Activity Concentrations and Associated Gamma Doses of 238U and 235U in Jordan
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作者 ABDUL-WALI M. S. AJLOUNI 《Journal of Physical Science and Application》 2015年第5期367-372,共6页
In this study, sixteen soil and vegetable samples from Tafila district were collected and analyzed from eight locations. Measurements of specific activity of natural gamma emitter radionuclides, 23SU and 235U, in thes... In this study, sixteen soil and vegetable samples from Tafila district were collected and analyzed from eight locations. Measurements of specific activity of natural gamma emitter radionuclides, 23SU and 235U, in these samples using gamma spectrometry, with the help of Genie 2000 software. Measurements were used to calculate the soil-vegetable transfer factor, and then the external radiation dose and internal radiation dose due to radioactivity of the ingested food. The specific activity of238U and 235U in soil were found to vary from (in Bq/kg): 26-575 and 1.4-35.5, respectively. The specific activity of 238U and 235U in vegetables were found to vary from (in Bq/kg): 0.019 to 0.632 and 0.0013-0.0375, respectively. The calculated transfer factor of Z3SU and Z35U range from 5.9 × 10^-4to 14.6 × 10^-4 for 238U and 4.9 × 10^-4 to 16.1 × 10^-4 for 235U. External absorbed dose rates were calculated to be in the range from 12.42 to 266.00 nGy/h. The annual effective dose was found to vary from 28.94 to 619.78 μSv/y. The annual internal effective dose due to 23SU and 23SU for fresh weights ofvegetablesl were found to vary from 0.9 × 10^-3 to 35.1 × 10^-3 μSv/y for 238U and 0.61 × 10^-4 to 17.62 × 10^-4 μSv/y for 235U. 展开更多
关键词 SOIL VEGETABLES gamma spectrometry environmental radioactivity Tafila JORDAN transfer factor internal dose external dose.
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Strategic Focus and Business Model Organization: The Mean Field Analysis Approach
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作者 Paola Pisano Daniele Manini +1 位作者 Marco Gribaudo Marco Pironti 《Journal of Modern Accounting and Auditing》 2011年第7期709-718,共10页
The objective of this research is to show a new methodology for modeling phenomena present in complex economic systems. The case study we analyzed is the adoption of open organization model among firms operating in a ... The objective of this research is to show a new methodology for modeling phenomena present in complex economic systems. The case study we analyzed is the adoption of open organization model among firms operating in a particular industry. A firm with an open system model creates and captures value taking advantage not only from the internal resource but also from external. The organization could approach to open model acquisition using different focus: external focus namely looking out of its boundary, acting and reacting to competitor innovation, costumers' changing, demand growth, or internal focus remaining inside its boundary improving its best capabilities ignoring what happened outside (Vagnani, Moran, & Simoni, 2010). The actors involved are firms, customers and suppliers linked together through a business to business model. The methodology is based on an Object-Oriented Analysis Field Model that allows to intuitively describe systems characterized by a large number of objects that interact, as in this case of a system composed by different organizational entities. The system simulation allows to analyze how the actors influence the acquisition and diffusion of the open organization model. This approach permits the generation of different classes of objects to represent all actors involved in the evolution of the system and to define the dynamics that determine their interaction. The solution of the model can be approximated using the Mean-Field analysis technique (Kurtz, 1978), following the results proposed in Bobbio, Gribaudo, and Yelek (2008). A qualitative result is illustrated in order to show the applicability of the proposed methodology and to emphasize its relevant features: flexible modeling approach, capacity of solving complex systems and output management facilities. The presented model is comprehensive and its scope is wide; it could be used to study the behavior of enterprises changing model in many different scenarios and situations. In future works quantitative results will be given, and different situations will be analyzed. 展开更多
关键词 DIFFUSION open organization model internal focus external focus mean field analysis
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The Tragedy of Unbalanced Personality——The Common Personality Psychological Reasons of the Destruction of Emily and Usher
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作者 胡星 《海外英语》 2014年第16期223-224,共2页
A Rose for Emily is the masterpiece of William Faulkner, who is regarded as the founder of Southern literature. The Fall of the House of Usher is one of the most popular short stories written by the great American wri... A Rose for Emily is the masterpiece of William Faulkner, who is regarded as the founder of Southern literature. The Fall of the House of Usher is one of the most popular short stories written by the great American writer Edgar Allan Poe. They have common ends that the main characters of the two novels—Emily and Usher are all destruction of their unbalanced personality.This thesis will set a new point from a branch view of psychology—personality psychology to analyze the two characters Emily and Usher, how they change from pathological personality to abnormal personality, and finally destruct from flesh to soul. The deep meaning is to announce the human inner world will distract by the outside world. 展开更多
关键词 TRIPARTITE structural model unbalanced PERSONALITY
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Mathematical modeling taking into account of intrinsic kinetic properties of cylinder-type vanadium catalyst
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作者 陈振兴 李洪桂 王零森 《中国有色金属学会会刊:英文版》 CSCD 2004年第3期613-618,共6页
The method to calculate internal surface effective factor of cylinder-type vanadium catalyst Ls-9 was given. Based on hypothesis of subjunctive one dimension diffusion and combined shape adjustment factor with three-s... The method to calculate internal surface effective factor of cylinder-type vanadium catalyst Ls-9 was given. Based on hypothesis of subjunctive one dimension diffusion and combined shape adjustment factor with three-step catalytic mechanism model, the macroscopic kinetic model equation about SO2 oxidation on Ls-9 was deduced. With fixed-bed integral reactor and under the conditions of temperature 350410 ℃, space velocity 1 8005 000 h-1, SO2 inlet content 7%12%, the macroscopic kinetic data were detected. Through model parameter estimation, the macroscopic kinetic model equation was obtained. 展开更多
关键词 有效因子 内表面 数学模型 宏观动力学 催化剂
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Is the Long-term Economic Decline of the Philippines Unstoppable? Trends, Reasons, Outlook
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作者 Peter Richter 《Journal of Sustainable Business and Economics》 2023年第4期1-19,共19页
The Philippines was in the 1960s a model of development in Asia and second to Japan,but occupies presently only the 11th position under South-East and East Asian countries in terms of GDP-per capita.The article explor... The Philippines was in the 1960s a model of development in Asia and second to Japan,but occupies presently only the 11th position under South-East and East Asian countries in terms of GDP-per capita.The article explores why this important Asian country with a long colonial past and enormous economic potential still ranks under lower-income countries and has in the last decades let pass by many other Asian countries.In answering this question,the approach of external triggers for accelerated development is being applied.In stark contrast to the success stories of the strongly outward-looking Asian countries like the four Tigers,later of Thailand and Vietnam the Philippines never developed a vision of an open economy connecting pro-actively to the world markets.Trade is hampered by a non-competitive and highly protected national economy.The existing FDI is more oriented to the profitable local markets.Foreign debts were never effectively used and international tourism was never well promoted.Linking these failures to the existing power structures in the country,it seems very much that the backward forces like the big landowners,the local producers and industrialists never wanted and continue not to want to open up the economy to international competition and governments are complacent with these groups.Various indicators demonstrate the long-term decline of the Philippines:Among them the slow growth of the GDP and the continuously high poverty rates.As the alliance of big business and policy holds firm no change in the failing nationalistic economic model can be detected leaving the bleak outlook that the economic decline will continue. 展开更多
关键词 external triggers of accelerated development strategies Promotion of exports Protection of local industries Foreign direct investments Foreign indebting International tourism Concentration of the national economy Failures of the development model
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基于外部和内部因素评价矩阵的圣彼得堡中医中心发展策略研究
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作者 李鹏 曹凤 +4 位作者 陈丹 王朝阳 刘清国 陈昕力 尤里·阿列克谢维奇 《世界中医药》 CAS 北大核心 2024年第8期1215-1222,共8页
目的:研究圣彼得堡中医中心发展中存在的问题,分析制约和影响其发展的内外部因素,为中医中心在俄罗斯的进一步良好发展提供一定的策略和建议。方法:通过环境因素评价矩阵的方法,分别使用外部因素评价(EFE)矩阵和内部因素评价(IFE)矩阵... 目的:研究圣彼得堡中医中心发展中存在的问题,分析制约和影响其发展的内外部因素,为中医中心在俄罗斯的进一步良好发展提供一定的策略和建议。方法:通过环境因素评价矩阵的方法,分别使用外部因素评价(EFE)矩阵和内部因素评价(IFE)矩阵对影响圣彼得堡中医中心发展的重要制约因素进行定量评价分析,对海外中医中心的未来发展进行科学而系统的研究,利用SWOT模型并由此判断中医中心发展所处的阶段,从而选择适宜的发展策略。结果:利用EFE和IFE矩阵中计算出的力度值,通过SWOT模型运算可得,重心P坐标是(0.2,0.41),可知P位于第一象限,位于机会型策略区。结论:目前适合圣彼得堡中医中心发展的应选择开拓型策略中的机会型,进而提出相应对策与建议,以保障发展策略落实,推进中医中心在俄罗斯的健康长远发展。 展开更多
关键词 俄罗斯 海外中医中心 发展策略 内部因素评价矩阵 外部因素评价矩阵 态势分析法 中医药 针灸
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随机噪声平板下光学复眼内外参联合标定
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作者 李东升 王国嫣 +2 位作者 刘锦新 范红旗 李飚 《电子与信息学报》 EI CAS CSCD 北大核心 2024年第7期2898-2907,共10页
光学复眼在无人系统的精确定位制导、避障导航等任务中得到了越来越广泛的应用,其中光学复眼的高精度标定是保障上述任务质量的前提。通常经典的张氏棋盘格标定法要求光学复眼的每个子眼都必须观测到完整的棋盘格,然而,由于光学复眼结... 光学复眼在无人系统的精确定位制导、避障导航等任务中得到了越来越广泛的应用,其中光学复眼的高精度标定是保障上述任务质量的前提。通常经典的张氏棋盘格标定法要求光学复眼的每个子眼都必须观测到完整的棋盘格,然而,由于光学复眼结构的复杂性,在实际标定过程中难以满足这一要求。为解决张氏标定法的局限性,该文提出一种基于随机噪声平板的光学复眼内外参联合标定算法,该算法通过子眼拍摄随机噪声平板的局部信息,可简单快速地实现任意构型和子眼数量的光学复眼内外参联合标定。为了提高光学复眼标定的稳定性,设置多阈值匹配机制解决子眼视场特征点数量稀疏导致图像匹配失效的问题。同时,给出了光学复眼内外参联合标定的误差模型,用来衡量所提出算法的精确度。在与张氏棋盘格标定法进行实验对比中,验证所提算法的稳定性和鲁棒性,并在光学复眼实物系统中,验证了所提联合标定算法具有较高的精度。 展开更多
关键词 光学复眼 随机噪声平板 内外参联合标定 平均重投影误差 广义相机模型
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弯管内外表面腐蚀缺陷力学-电化学相互作用规律研究
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作者 张鹏 赵明 +1 位作者 罗梓洋 许田 《中国安全生产科学技术》 CAS CSCD 北大核心 2024年第8期104-111,共8页
为进一步研究弯管内外表面腐蚀缺陷力学-电化学(M-E)相互作用规律,建立基于多物理场耦合的弯管内外表面含腐蚀缺陷的三维模型,研究内压和缺陷几何形状对M-E相互作用规律及对弯管的影响。研究结果表明:当弯管内外表面存在腐蚀缺陷时,弯... 为进一步研究弯管内外表面腐蚀缺陷力学-电化学(M-E)相互作用规律,建立基于多物理场耦合的弯管内外表面含腐蚀缺陷的三维模型,研究内压和缺陷几何形状对M-E相互作用规律及对弯管的影响。研究结果表明:当弯管内外表面存在腐蚀缺陷时,弯管内侧的M-E效应更强,增加应力和腐蚀的增长速率,使内侧更容易发生失效;当缺陷几何增长时,应力在缺陷长度和宽度方向上增长,腐蚀主要在缺陷长度方向上增长;外表面缺陷附近的应力和腐蚀增长规律基本一致,而内表面缺陷附近的应力增长较腐蚀增长更为复杂。研究结果可为含腐蚀缺陷弯管评估模型的完善以及管道系统完整性的管理提供理论参考。 展开更多
关键词 弯管 内外表面缺陷 腐蚀 多物理场耦合模型 有限元分析
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我国农产品国际竞争力评价及影响因素分析
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作者 徐玉梅 刘爽 《南方农村》 2024年第3期19-25,共7页
经济全球化发展的格局下,我国作为传统农业大国,发展农产品国际贸易,提升农产品国际竞争力,是进一步扩大高水平开放、加快融入世界经济的重要组成部分。基于对我国农产品国际贸易发展现状分析,运用国际市场占有率、贸易竞争力指数以及... 经济全球化发展的格局下,我国作为传统农业大国,发展农产品国际贸易,提升农产品国际竞争力,是进一步扩大高水平开放、加快融入世界经济的重要组成部分。基于对我国农产品国际贸易发展现状分析,运用国际市场占有率、贸易竞争力指数以及显示性比较优势指数对我国农产品的国际竞争力进行测算,并通过钻石模型分析影响我国农产品国际竞争力的因素,最后提出针对性的对策建议,以期提升我国农产品国际竞争力。 展开更多
关键词 农产品 国际竞争力 钻石模型 影响因素
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“中国海洋强国建设的重要成就与启示”笔谈
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作者 曲金良 秦立志 金永明 《中国海洋大学学报(社会科学版)》 2024年第4期1-10,共10页
自党的十八大报告完整提出中国海洋强国战略以来,通过顶层设计、理论阐释、内涵拓展、布局实践,中国海洋强国建设成就斐然,为构建海洋命运共同体作出了重大贡献。但中国的海洋强国战略实施依然面临多种问题和挑战,需要不断增强主体自觉... 自党的十八大报告完整提出中国海洋强国战略以来,通过顶层设计、理论阐释、内涵拓展、布局实践,中国海洋强国建设成就斐然,为构建海洋命运共同体作出了重大贡献。但中国的海洋强国战略实施依然面临多种问题和挑战,需要不断增强主体自觉、理论自洽和文化自信,也需要在海权的发展进程中,结合实际,把握机遇,确保海洋强国战略目标如期实现,还需要消除南海问题对推进海洋强国建设的不利影响,合理处理影响南海问题的内外因素,确保中国海洋强国建设的顺利推进,为我国强国建设作出“海洋贡献”。 展开更多
关键词 海洋强国战略 文化自信 海权战略 内外因素 南海权益
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基于Logistic回归的国际时尚品牌销售渠道选择影响因素分析
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作者 田欢 《毛纺科技》 CAS 北大核心 2024年第1期51-58,共8页
为了帮助国际时尚品牌合理、科学地选择销售渠道和制定销售策略,以满足不同地区不同类型消费者的需求,提高品牌市场竞争力。首先依据访谈数据确定分析因子,建立影响国际时尚品牌销售渠道选择的多因素分析理论模型,提出可能影响国际品牌... 为了帮助国际时尚品牌合理、科学地选择销售渠道和制定销售策略,以满足不同地区不同类型消费者的需求,提高品牌市场竞争力。首先依据访谈数据确定分析因子,建立影响国际时尚品牌销售渠道选择的多因素分析理论模型,提出可能影响国际品牌销售渠道选择的消费者偏好分析指标体系,从消费者个人特征、心理偏好、品类偏好以及时尚认知4个维度设计问卷并进行调研。运用SPSS软件对问卷回收数据进行录入,并采用Logistic回归分析数据,从而验证模型假设。通过分析结果可知,以上4个维度下的诸多影响因子均对国际品牌销售渠道的选择产生显著影响,并给出了具体的指导策略。品牌商可以根据研究结果制定对应的销售策略,以有效提高销售渠道利用率,最大化提升品牌销售业绩。 展开更多
关键词 销售渠道 国际时尚品牌 LOGISTIC回归 影响因子
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基于内外场一体化的水面舰艇作战模型检验评估方法
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作者 韩春亮 顾吉堂 穆琳 《舰船电子工程》 2024年第4期100-103,123,共5页
针对水面舰艇作战模型检验验证与评估难题,研究作战模型检验评估需求和内容体系,提出基于内外场一体化的检验评估流程和方法,大样本多维度评价作战模型,提高模型的规范性和质量效能。
关键词 水面舰艇 作战模型 内外场一体化 检验评估
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影响植物蛋白溶解性内外因素研究现状
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作者 王悦 王远利 +3 位作者 王紫琳 管春花 陶亮 田洋 《食品与发酵工业》 CAS CSCD 北大核心 2024年第20期375-384,共10页
植物蛋白具有资源丰富、营养价值优良、价格低廉、环境污染小的优点,是十分优质的食品加工原辅料。但大部分植物蛋白水溶性较差,应用于水基食品中常存在产品稳定性差、易沉淀、口感不佳的缺陷,在实际生产加工中应用受限。植物蛋白精深... 植物蛋白具有资源丰富、营养价值优良、价格低廉、环境污染小的优点,是十分优质的食品加工原辅料。但大部分植物蛋白水溶性较差,应用于水基食品中常存在产品稳定性差、易沉淀、口感不佳的缺陷,在实际生产加工中应用受限。植物蛋白精深加工产业发展不足,大量蛋白质资源仅用作饲料或肥料,不仅资源浪费极大且污染环境。目前,随着植物基产品的不断发展,关于植物蛋白溶解度及增溶技术的相关研究逐渐成为热点,并取得一定进展,但相关内容及研究结果的综合论述较少。因此,该文旨在综述影响植物蛋白溶解性的内外因素,并整理提高溶解度的相关技术,以期为植物蛋白增溶技术发展及植物蛋白产品研发提供理论参考。 展开更多
关键词 植物蛋白 溶解性 内部因素 外部因素
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专精特新企业数字化转型影响因素分析 被引量:3
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作者 孔雯 《企业经济》 北大核心 2024年第3期90-102,共13页
随着我国经济由高速增长阶段转向高质量发展阶段,必须加快推进专精特新企业数字化转型,提升企业的核心竞争力,推动制造业向高端化、智能化以及绿色化方向发展。本文以2013—2022年上市专精特新企业为研究对象,从企业内部因素和外部因素... 随着我国经济由高速增长阶段转向高质量发展阶段,必须加快推进专精特新企业数字化转型,提升企业的核心竞争力,推动制造业向高端化、智能化以及绿色化方向发展。本文以2013—2022年上市专精特新企业为研究对象,从企业内部因素和外部因素两方面探究上市专精特新企业数字化转型的影响因素。研究发现:企业内部因素中,专精特新企业更高的经营效率、更高的人力资本以及CEO信息技术背景能够促进企业数字化转型;企业外部因素中,更高的行业数字化转型水平、更多的政府补助能够促进企业数字化转型,更高的经济政策不确定性则会抑制企业数字化转型。据此,本文提出应提高人力资本、加大政策支持力度、因地施策从而助力专精特新企业的数字化转型。 展开更多
关键词 专精特新企业 数字化转型 内部因素 外部因素
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足月臀位外倒转术成功预测模型的建立与验证
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作者 吴英 周建新 姜海利 《现代妇产科进展》 2024年第9期670-674,共5页
目的:建立单胎足月臀位外倒转术成功的预测模型并进行内部验证。方法:回顾分析2015年1月至2021年9月在首都医科大学附属北京妇产医院行臀位外倒转术的485例单胎臀位孕妇的临床资料,按手术结局分为成功组和失败组。采用logistic回归模型... 目的:建立单胎足月臀位外倒转术成功的预测模型并进行内部验证。方法:回顾分析2015年1月至2021年9月在首都医科大学附属北京妇产医院行臀位外倒转术的485例单胎臀位孕妇的临床资料,按手术结局分为成功组和失败组。采用logistic回归模型进行多因素分析,筛选出外倒术成功的影响因素作为预测因子建立预测模型,应用R软件构建预测模型的列线图。绘制受试者工作特征(ROC)曲线对模型预测性能进行评估,并运用Bootstrap法进行内部验证。结果:经产、宫缩抑制剂使用、胎儿体重<2960g、羊水指数≥11.3cm、非前壁胎盘、脐绕颈<2周是外倒转术成功的独立有利因素,纳入上述6个因素作为预测因子,建立外倒转术成功的预测模型及列线图。该预测模型的ROC曲线下面积为0.74(95%CI为0.70~0.79),此时灵敏度为71.43%,特异度为67.38%。模型的内部验证结果提示其预测曲线与临床实际曲线一致性良好。结论:基于上述预测因子建立的足月臀位外倒转术成功的预测模型具有较好的预测效能,可为临床医生进行临床咨询和选择外倒转术的适宜人群提供参考。 展开更多
关键词 臀位 外倒转术 成功 预测模型 内部验证
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心房颤动患者华法林抗凝治疗初期发生抗凝过度的影响因素研究
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作者 范彩霞 李娇 +4 位作者 魏延津 郭德群 刘存飞 李峥嵘 邱石 《中国全科医学》 北大核心 2024年第3期308-314,共7页
背景心房颤动发病率高,是引起脑卒中、心血管疾病及全因死亡的重要危险因素,而适当的抗凝治疗是预防心房颤动相关性卒中的核心。华法林仍然是目前主要的抗凝药物,但其治疗窗较窄,固定剂量的华法林在治疗初期很容易导致过度或抗凝治疗不... 背景心房颤动发病率高,是引起脑卒中、心血管疾病及全因死亡的重要危险因素,而适当的抗凝治疗是预防心房颤动相关性卒中的核心。华法林仍然是目前主要的抗凝药物,但其治疗窗较窄,固定剂量的华法林在治疗初期很容易导致过度或抗凝治疗不足,既往华法林抗凝过度的临床研究较少。目的分析心房颤动患者华法林抗凝治疗初期发生抗凝过度的流行病学和临床特征,并探讨发生抗凝过度的影响因素。方法该研究为单中心回顾性队列研究。纳入2017年1月—2022年12月临沂市人民医院收治的行华法林2.5 mg/d治疗的心房颤动患者552例为研究对象,收集患者临床资料,包括年龄、性别、体质量、心房颤动类型(非瓣膜型/瓣膜型)、合并疾病(高血压、糖尿病、低蛋白血症、转氨酶异常、心力衰竭)、联合用药情况(联合用药数量、联用抗菌药物、联用胺碘酮),收集患者治疗前实验室检查结果,包括血清白蛋白(Alb)、血清肌酐(Scr)、血清丙氨酸氨基转移酶(ALT)及血清天门冬氨酸氨基转移酶(AST)水平,收集患者治疗前国际标准化比值(INR)和用药7 d后INR。根据华法林治疗7 d后INR是否>3.0将患者分为抗凝过度组(INR>3.0,n=122)和未抗凝过度组(INR≤3.0,n=430),比较两组患者资料,并采用单因素及多因素Logistic回归分析探究华法林抗凝治疗初期发生抗凝过度的影响因素。结果抗凝过度组患者年龄,女性、瓣膜型心房颤动、低蛋白血症、转氨酶异常比例,联合用药数量,联用胺碘酮比例,AST高于未抗凝过度组;体质量、高血压比例、糖尿病比例、Alb、ALT低于未抗凝过度组(P<0.05)。多因素Logistic回归分析结果显示,年龄≥65岁(OR=1.954,95%CI=1.243~3.073,P=0.004)、体质量≤63 kg(OR=2.967,95%CI=1.841~4.783,P<0.001)、联合用药数量>5种(OR=1.976,95%CI=1.175~3.323,P=0.010)、Scr≥91μmol/L(OR=2.087,95%CI=1.222~3.561,P=0.007)是心房颤动患者华法林抗凝治疗初期发生抗凝过度的独立危险因素,而糖尿病(OR=0.424,95%CI=0.191~0.939,P=0.034)是心房颤动患者华法林抗凝治疗初期发生抗凝过度的保护因素。结论年龄≥65岁、体质量≤63 kg、联合用药数量>5种、Scr≥91μmol/L可能是心房颤动患者华法林抗凝治疗初期发生抗凝过度的危险因素,而糖尿病可能是心房颤动患者华法林抗凝治疗初期发生抗凝过度的保护因素。对于高龄、低体质量、多种药物联合使用、Scr水平升高的华法林抗凝治疗患者应密切监测INR水平。 展开更多
关键词 心房颤动 华法林 国际标准化比值 抗凝过度 危险因素 LOGISTIC模型
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