摘要
目的:探讨CHA_2DS_2-VASc评分与同型半胱氨酸对非瓣膜性心房颤动患者发生血栓事件的预测价值。方法:选取非瓣膜性心房颤动住院患者228例,根据是否发生血栓事件,分为血栓组146例和非血栓组82例,比较两组CHA_2DS_2-VASc评分、同型半胱氨酸的差异,通过Logistic回归分析和ROC曲线评估二者结合对非瓣膜性心房颤动患者发生血栓事件的预测价值。结果:血栓组CHA_2DS_2-VASc评分、同型半胱氨酸、D-二聚体、纤维蛋白原及低密度脂蛋白水平均显著高于非血栓组;Logistic回归分析显示CHA_2DS_2-VASc评分≥2分、同型半胱氨酸>15.0μmol/L是发生血栓事件的独立危险因素(P<0.05)。ROC曲线显示CHA_2DS_2-VASc评分和同型半胱氨酸预测血栓事件的曲线下面积分别为0.752(95%CI:0.654-0.762)和0.797(95%CI:0.709-0.825),二者联合预测血栓事件的曲线下面积为0.869(95%CI:0.827-0.918),显著高于二者单用(P<0.05)。结论:CHA_2DS_2-VASc评分和同型半胱氨酸对非瓣膜性心房颤动患者发生血栓事件具有较高的预测价值,CHA_2DS_2-VASc评分≥2分且伴有同型半胱氨酸升高的非瓣膜性房颤患者是发生血栓事件的极高危人群。
Objective： To discuss the predictive value of CHA2DS2-VASc score and homocysteine for the incidence of thrombotic events in patients with non-valvular atrial fibrillation. Methods： 228 patients with nonvalvular atrial fibrillation were selected and divided into the thrombosis group （n=146） and non thrombosis group （n=82）. The CHA2DS2-VASc score and serum homocysteine level were compared between the two groups. The predictive accuracy of combination of CHA2DS2-VASc score and serum homocysteine level for thrombosis events were analyzed by Logistic regression analysis and ROC curve. Results： Compared with the non-thrombosis group, the CHA2DS2-VASc score, homocysteine, D-dimer, fibrinogen and low density lipoprotein levels were higher in the thrombosis group. Logis- tic regression analysis showed that CHA2DS2-VASc score a 2 points, homocysteine 〉15.0 p^mol/L were independent risk factors for thrombosis in the patients with non-valvular atrial fibrillation （P〈0.05）. ROC curve showed that the area under the curve of CHA2DS2-VASc score and homocysteine were 0.752（95% CI：0.654-0.762） and 0.797（95% CI：0.709-0.825） respectively. The area under the curve to of CHA2DS2-VASc score combined with homocysteine to predict the thrombosis events in the patients with non-valvu- lar atrial fibrillation was 0.869（95%CI：0.827-0.918）, which was significantly higher than CHA2DS2-VASc score and homocysteine alone （P〈0.05）. Conclusion： Both CHA2DS2-VASc score and homocysteine levels had high predictive value for the thrombus. The patients with the CHA2DS：-VASc score〉 2 and high homocysteine level were extremely high risk of thromboembolic events occurred in non valvular atrial fibrillation.
出处
《现代生物医学进展》
CAS
2017年第33期6450-6454,共5页
Progress in Modern Biomedicine
基金
国家自然科学基金面上项目(81471399)
