摘要
目的探讨CHA2DS2-VASc评分法对非瓣膜病性心房纤颤(房颤)患者继发脑梗死的风险评估作用。方法分别采用CHADS2和CHA2DS2-VASc评分标准对208例非瓣膜病性房颤患者进行评分,并随访1年观察患者脑梗死的发生率。结果 CHADS2和CHA2DS2-VASc评分法预测房颤患者1年内脑梗死风险的受试者工作曲线下面积(AUCROC)分别为0.66和0.74。CHA2DS2-VASc评分低危组10例患者均未继发脑梗死,中危组28例患者中1例(3.6%)继发脑梗死,高危组170例患者中23例(13.5%)继发脑梗死;3组间脑梗死发生率比较,差异有统计学意义(均P<0.05)。直线回归分析显示,CHA2DS2-VASc评分与房颤患者继发脑梗死呈正相关(r=0.373,P=0.001)。CHA2DS2-VASc评分标准中,不同性别房颤患者继发脑梗死的差异无统计学意义(P>0.05),其余各项差异均有统计学意义(均P<0.05)。结论 CHA2DS2-VASc评分法可较准确评估非瓣膜病性房颤患者继发脑梗死的风险。
Objective To explore the evaluation effects of CHA2DS2-VASc scale on risk of nonvalvular atrial fibrillation patients with secondary cerebral infarction. Methods Two hundred and eight patients were evaluated by CHADS2 scale and CHA2DS2-VASc scale. The occurrences of cerebral infarction within one year followed up were observed. Results The area under the receiver operative characteristic （ AUCROC ） of CHADS2 and CHA2DS2-VASc were 0.66 and 0.74 in predicting the risk of cerebral infarction within one year. According to CHA2DS2-VASc criteria, There was no secondary cerebral infarction in low risk group; just one patient （3.6%） had secondary cerebral infarction in medium risk group; while 23 patients （ 13.5% ） had secondary cerebral infarction in high risk group. There were statistical differences in the incidence of cerebral infarction among three groups （ all P 〈 0. 05 ）. The linear regression analysis showed that CHA2DS2-VASc score was positive correlation with the occurrence of cerebral infarction in nonvalvular atrial fibrillation patients （ r = 0. 373, P = 0. 001 ）. According to CHA2DS2-VASc criteria, the incidence of cerebral infarction was no statistical difference between different sex patients （ P 〉 0.05 ） , while other score items had statistical differences （all P 〈 0. 05 ）. Conclusion CHA2DS2-VASc scale can effectively predict the risk of nonvalvular atrial fibrillation patients with secondary cerebral infarction.
出处
《临床神经病学杂志》
CAS
北大核心
2013年第3期183-186,共4页
Journal of Clinical Neurology
