摘要
目的比较CHADS2和CHA2DS2-VASc 2种评分方法对心房颤动(房颤)人群的缺血性脑卒中风险评估的差异。方法采用前瞻性队列研究方法,对143例新发非瓣膜性房颤患者,用CHADS2和CHA2DS2-VASc 2种评分方法进行卒中风险评估,比较2种评估方法得分以及卒中危险分层的差异。结果 CHADS2平均得分为(1.51±1.28)分,CHA2DS2-VASc平均得分为(2.36±1.97)分,后者明显高于前者(P<0.01);CHA2DS2-VASc评分低危组19例(13.3%),低于CHADS2评分低危组的46例(32.2%)(χ2=11.21,P<0.01);CHA2DS2-VASc评分中危组的32例(22.4%),低于CHADS2评分中危组42例(29.4%)(χ2=4.57,P<0.01);CHA2DS2-VASc评分高危组的92例(64.3%),高于CHADS2评分高危组55例(38.5%)(χ2=20.76,P<0.01);CHADS2评分法中,低度、中度、高度风险组,脑卒中发生例数分别为1、2、3例;CHA2DS2-VASc评分法中,低度、中度、高度风险组脑卒中发生例数分别为0、0、6例。结论与CHADS2评分法比较,CHA2DS2-VASc评估卒中风险中、低危组比例降低,高危组比例升高。
Objective To compare the results of ischemic stroke risk assessment in patients with newly diagnosed non-valvular atrial fibrillation （AF） using CHADS2 （ congestive heart failure, hypertension, age ≥ 75 years, diabetes, prior stroke or transient ischemic attack or thromboembolism[ doubled] ） and CHA2DS2-VASc（ congestive heart failure ,hyper- tension, age ≥ 75 years [ doubled ], diabetes, prior stroke or transient ischemic attack or thromboembolism [ doubled ], vascular disease, age 65 - 74 years, sex category） classification schemes for the appropriate application of the schemes among Chinese patients. Methods With prospective cohort design,the stroke risk of 143 patients with newly diagnosed non-valvular atrial fibrillation were assessed using CHADS2 and CHARDSz-VASc score and the results of assessment with the two schemes were compared. Results The average score of CHA2DS2-VASc was significantly higher than that of CHADS2 （2.36 ± 1.97 vs. 1.51 ± 1.28,P 〈 0.01 ）. Based on the scores of CHADS2, the proportions of the patients with low,intermediate, and high stroke risk were 32. 2% （46/143）, 29. 4% （42/143）, and 38. 5% （55/143）, while based on the scores of CHA2DS2-VASc ,the proportions were 13.3% （ 19/143 ） ,22. 4% （ 32/143 ）, and 64. 3% （ 92/143 ）, respec- tively, with a significantly lower proportion of low stroke risk（x2 = 4. 57, P 〈 0.01 ）and a significantly higher proportion of high stoke risk（x2 = 20. 76,P 〈 0. 05 ） for using CHAzDSz-VASc compared to using CHADS2. During the two-year follow-up,the number of stroke incident in the patients with low, intermediate, and high stroke risk assessed with CHADS2 were 1,2, and 3, whereas the number were 0,0,6 assessed with CHA2DS2-VASc, respectively. Conclusion Compared to with CHADS2, stroke risk assessment with CHA2DS2-VASc results in a lower proportion of low risk and a higher proportion of high risk among newly diagnosed Chinese non-valvular AF patients.
出处
《中国公共卫生》
CAS
CSCD
北大核心
2015年第9期1179-1181,共3页
Chinese Journal of Public Health
