CHA2 DS2-VASc 评分联合左心房内径对非瓣膜性心房颤动患者脑卒中风险的预测价值

摘要

Objective To explore the predictive value of CHA2 DS2-VASc score combined with left atrial diameter for the risk of stroke in patients with non-valvular atrial fibrillation (NVAF).Methods A total of 230 patients with NVAF were selected.CHA2 DS2-VASc score was calculated for each patient by the clinical history and auxiliary examination.All patients were followed up for one year after discharging from hospital,and the follow-up visit would be finished if patients suffered from stroke or followed up for one year.The patients were divided into stroke group and non-stroke group according to the follow-up results.Results The CHA2 DS2-VASc score and left atrial diameter in the stroke group were higher than those of non-stroke group.The area under the ROC curve of CHA2 DS2-VASc score,left atrial diameter and CHA2 DS2-VASc score combined with left atrial diameter to predict the happening of stroke in patients with NVAF were respectively 0.789,0.753 and 0.835. There were significant difference in area under the ROC curve among CHA2 DS2-VASc score,left atrial diameter and CHA2 DS2-VASc score combined with left atrial diameter(P <0.01 ).Conclusion The predictive value of CHA2 DS2-VASc score combined with left atrial diameter is higher for the occurrence of stroke in patients with NVAF.%目的：探讨 CHA2 DS2-VASc 评分联合左心房内径预测非瓣膜性心房颤动(房颤)患者发生脑卒中风险的价值。方法共纳入230例非瓣膜性房颤患者,依据病史及辅助检查计算 CHA2 DS2-VASc 评分。于患者出院后随访1年,随访期间若患者发生脑卒中或随访满1年则随访结束,根据随访结果将患者分为脑卒中组和非脑卒中组。结果脑卒中组 CHA2 DS2-VASc 评分、左心房内径较非脑卒中组偏高,CHA2 DS2-VASc 评分、左心房内径、CHA2 DS2-VASc 评分联合左心房内径预测非瓣膜性房颤患者发生脑卒中的 ROC 曲线下面积分别为0.789、0.753、0.835；CHA2 DS2-VASc 评分联合左心房内径的 ROC 曲线下面积与 CHA2 DS2-VASc 评分、左心房内径的 ROC 曲线下面积比较差异有统计学意义(P <0.01)。结论 CHA2 DS2-VASc 评分联合左心房内径对非瓣膜性房颤患者发生脑卒中的风险有更高的预测价值。