摘要
目的探讨颈动脉粥样硬化斑块对老年非瓣膜性心房颤动(NVAF)病人缺血性脑卒中事件的预测价值。方法纳入303例NVAF病人,根据是否合并缺血性脑卒中分为房颤伴脑卒中组(n=134)和房颤不伴脑卒中组(n=169)。采用单因素及多因素回归分析探讨NVAF病人缺血性脑卒中的预测因素,并进一步评估其预测价值。结果房颤伴脑卒中组中75.4%的病人存在颈动脉粥样硬化斑块,而非脑卒中组伴有颈动脉粥样硬化斑块的病人比例为66.3%,差异有统计学意义(P<0.05)。Logistic回归分析结果表明,颈动脉粥样硬化斑块以及CHA_(2)DS_(2)-VASc评分是NVAF病人缺血性脑卒中事件的独立危险因素。ROC曲线分析结果表明,颈动脉粥样硬化斑块联合CHA_(2)DS_(2)-VASc评分预测缺血性脑卒中的价值优于CHA_(2)DS_(2)-VASc评分。结论在老年NVAF病人中,颈动脉粥样硬化斑块与缺血性脑卒中事件密切相关。颈动脉粥样硬化斑块联合CHA_(2)DS_(2)-VASc评分预测缺血性脑卒中事件的价值优于CHA_(2)DS_(2)-VASc评分。
Objective To explore the predictive value of carotid atherosclerosis plaque for ischemic stroke events in the elderly patients with nonvalvular atrial fibrillation(NVAF).Methods A total of 303 patients with NVAF were enrolled in the study,and were divided into the atrial fibrillation with stroke group(n=134)and the atrial fibrillation without stroke group(n=169)based on whether they suffered from ischemic stroke events.The predictive factors of ischemic stroke in the patients with NVAF were analyzed by single and multivariate regression analysis,and the predictive value was further evaluated by receiver operating characteristic(ROC)curve.Results Among the patients with atrial fibrillation and stroke,75.4%presented with carotid atherosclerosis plaque,compared with 66.3%in the patients without stroke(P<0.05).Logistic regression analysis showed that carotid atherosclerosis plaque and CHA_(2)DS_(2)-VASc score were the independent risk factors for ischemic stroke in the patients with NVAF.ROC curve analysis showed that the predictive value of carotid atherosclerosis plaque combined with CHA_(2)DS_(2)-VASc score was better than that of CHA_(2)DS_(2)-VASc score alone.Conclusions In the elderly patients with NVAF,carotid atherosclerosis plaque is closely related to ischemic stroke events.The value of carotid atherosclerosis plaque combined with CHA2DS2-VASc score in predicting ischemic stroke events may be better than CHA_(2)DS_(2)-VASc score alone.
作者
张丽莉
李静
丁林锋
孙静娴
蔡静波
ZHANG Lili;LI Jing;DING Linfeng;SUN Jingxian;CAI Jingbo(Jiangsu Health Vocational College,Nanjing 211800,China;Department of Cardiology,Geriatric Hospital of Nanjing Medical University,Nanjing 210024,China)
出处
《实用老年医学》
CAS
2024年第3期236-239,共4页
Practical Geriatrics
基金
江苏卫生健康职业学院校级科研项目(JKC2021004)。
