摘要
目的：探讨非瓣膜病房颤卒中风险评分（CHA2DS2-VASc）与老年非瓣膜性心房颤动（NVAF）合并缺血性脑卒中（ICS）患者短期预后的关系。方法：入选我院2011年6月到2013年8月住院的206例老年NVAF合并ICS患者,应用CHA2DS2-VASc进行评分,分为低危组（24例,0分）、中危组（78例,1分）和高危组（104例,2-9分）。在发病后3个月时,采用改良Rankin量表（mRS）评定患者的预后,根据mRS得分将患者分为预后良好组（89例,0-2分）和预后不佳组（117例,3-6分）。分析患者3个月预后不佳的独立预测因素。结果：中危和高危组在年龄、高血压、糖尿病、心力衰竭、卒中、血管疾病史比例和美国国立卫生研究院卒中量表（NIHSS）评分显著高于低危组（P〈0.05或〈0.01）。与预后良好组比较,预后不佳组年龄[（72.81±7.68）岁比（81.56±8.03）岁]、高血压（58.4%比71.8%）、卒中史比例（9.0%比29.9%）、NIHSS评分[（2.97±1.42）分比（7.67±3.92）分]和CHA2DS2-VASc评分[（1.70±1.63）分比（4.03±2.53）分]显著升高,P〈0.05或〈0.01。多因素Logistic回归分析显示NIHSS评分（高危：OR=1.78,95%CI：1.27-2.56,P=0.001）、CHA2DS2-VASc评分（高危：OR=3.24,95%CI：1.32-6.98,P=0.001）和年龄（高危：OR=1.23,95%CI：1.07-1.54,P=0.01）是老年NVAF合并ICS患者3个月预后不佳的独立预测因素。结论：CHA2DS2-VASc评分与NVAF合并ICS早期病情改善有关,年龄、NIHSS评分和CHA2DS2-VASc评分是短期预后不佳的独立预测因素。
Objective：To explore the relationship between atrial fibrillation stroke risk score（CHA2DS2-VASc score）and short-term prognosis of aged patients with nonvalvular atrial fibrillation（NVAF）complicated ischemic cerebral stroke（ICS）.Methods：A total of 206 aged NVAF＋ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were divided into low risk group（n=24,0score）,medium risk group（n=78,1score）and high risk group（n=104,2-9scores）.Modified Rankin scale（mRS）was used to assess patients＇ prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group（n=89,0-2scores）and poor prognosis group（n=117,3-6scores）.Independent predictors for poor prognosis in three months were analyzed.Results：Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus（DM）,heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score（NIHSS）in medium and high risk groups（P〈0.05or〈0.01）.Compared with good prognosis group,there were significant rise in age[（72.81±7.68）years vs.（81.56±8.03）years],percentages of hypertension（58.4% vs.71.8%）and stroke history（9.0% vs.29.9%）,scores of NIHSS [（2.97±1.42）scores vs.（7.67±3.92）scores]and CHA2DS2-VASc[（1.70±1.63）scores vs.（4.03±2.53）scores]in poor prognosis group,P〈0.05or〈0.01.Multi-factor Logistic regression analysis indicated NIHSS score（high risk：OR=1.78,95%CI：1.27-2.56,P =0.001）,CHA2DS2-VASc scores（high risk：OR=3.24,95%CI：1.32-6.98,P=0.001）and age（high risk：OR=1.23,95%CI：1.07-1.54,P=0.01）were independent predictors for poor prognosis on three months in aged NVAF ＋ICS patients.Conclusion：CHA2DS2-VASc score is related to early improvement of patients with NVAF ＋ ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.
出处
《心血管康复医学杂志》
CAS
2016年第2期136-141,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心房颤动
卒中
预后
老年人
Atrial fibrillation
Stroke
Prognosis
Aged
