摘要
目的研究CHA2DS2-VASe评分与颅内动脉粥样硬化、卒中分型、早期预后的关系，以评价CHA2DS2-VASc评分的临床价值。方法回顾性分析149例非瓣膜性房颤（non-valvular atrial fibrillation，NVAF）缺血性脑卒中患者的临床表现、常规实验室检查、彩超和颅脑CT等辅助检查，以及CHA：DS：一VASc评分、中国缺血性卒中亚型（Chinese ischemic stroke subclassification，CISS）分型、人院和出院时美国国立卫生研究院卒中量表（Na-tional Institutes of Health stroke scale，NIHSS）评分等。结果合并颅内动脉粥样硬化的患者以及CHA2DS2-VASc评分高于未合并者[（5．13±1．39）vs．（4．14±1．67）】，差异有统计学意义（P〈0．05）；不同CHA2DS2-VASc评分组（0-1分组，2-3分组，4-5分组，≥6分组）患者合并颅内动脉硬化的分布情况有统计学差异（P〈0．05）。CS＋LAA组与CS＋LAA＋PAD组患者CHA2DS2-VASc评分分别与CS组、CS＋PAD组患者比较均有统计学差异（均P〈0．01）。不同CHA：DS：-VASc评分组患者病情改善情况比较有统计学差异（P〈0．05）；病情改善组与未改善组的患者CHA2DS2-VASc评分比较亦存在统计学差异（P〈0．05）。结论较高的CHA2DS2-VASc评分与NVAF缺血性脑卒中患者合并颅内动脉粥样硬化机率增加有关；CHA2DS2-VASc评分可以帮助推测NVAF患者发生缺血性脑卒中的类型和发病机制；CHA2DS2-VASc评分与NVAF缺血性脑卒中严重程度及早期病情改善相关。
Objective To study the relationship between CHA2DS2-VASc score and intracranial atherosclerosis, Chinese ischemic stroke subclassification （CISS） classification and the early neurological outcomes in ischemie stroke pa-tients with non-valvular atrial fibrillation （NVAF）, and to evaluate the clinical value of CHA2DS2-VASc score. Methods The retrospective analysis method was used. The data from 149 cases of ischemic stroke patients with NVAF was retro- spectively analyzed. The clinical data mainly included clinical manifestations, routine lab tests, imaging examinations such as the color-echo doppler, brain CT and/or MRI and angiographic studies of CTA and/or MRA of brain, CHA2DS2-VASc score, the CISS and the National Institutes of Health stroke scale （NIHSS）. Results The CHA2DS2-VASc score was significantly higher in patients with intracranial atherosclerosis than those without [（5.13 ± 1.39） vs. （4.14± 1.67）] （P〈0.05）. The occurrence rates of intracranial atherosclerosis were significantly different among dif- ferent CHA2DS2-VASc score subgroups （0-1, 2-3, 4-5 and ≥6 subgroups） （P〈0.05）. There were significant differences in CHA2DS2-VASc score among CS＋LAA group, CS＋LAA＋PAD,group CS, group and CS＋PAD group （all P〈0.05）. There was statistical difference in CHA2DS2-VASc score between patients with and without improvements （P〈0.05）. Conelu-sion The CHA2DS2-VASc score may be associated with concomitant intracranial atherosclerosis of ischemic stroke pa-tients with NVAF which can be used to predict the condition of intracranial atherosclerosis. The CHA2DS2-VASc score is positively correlated with severity of ischemic stroke with NVAF which can be used to predict the disease improvements in patient with NVAF.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2014年第1期21-25,共5页
Chinese Journal of Nervous and Mental Diseases
