CHA2DS2-VASc评分法对非瓣膜病性心房纤颤患者继发脑梗死的风险评估作用

摘要

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.%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(AUGROC)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.