STAF及LADS评分筛查急性缺血性脑卒中患者合并心房颤动的临床研究  

STAF and LADS score for screening atrial fibrillation in patients with acute ischemic stroke:a clinical research

作　　者：袁振华[1] 关景霞[1] 卢祖能[1] 

机构地区：[1]武汉大学人民医院神经内科,430060

出　　处：《卒中与神经疾病》2016年第1期21-25,共5页Stroke and Nervous Diseases

基　　金：湖北省卫计委重点项目(WJ2015MA007);武汉市科技局2015年应用基础研究计划项目(2015060101010047);国家自然科学基金资助项目(项目批准号为81301010)

摘　　要：目的探讨STAF评分（score for the targeting of atrial fibrillation）及LADS评分（1eft atrial diameter,age,diagnosis of stroke or TIA,smoking）对急性缺血性脑卒中患者合并心房颤动（AF）的筛查价值。方法纳入2013年12月~2014年12月就诊于本科且临床诊断为急性缺血性脑卒中的患者,记录人口学信息、入院后首次美国国立卫生研究院卒中量表评分（NIHSS）,以及普通和/或长程心电图、心脏彩超、头颈部血管评估等检查结果。分别对所有患者进行STAF及LADS评分,绘制受试者工作特征（ROC）曲线,以确定STAF和LADS评分诊断AF的最佳截断点,计算出各自的灵敏度与特异度。结果共纳入331例患者,其中男211例,女120例,年龄31~92岁,平均年龄（64±3.5）岁。STAF评分诊断AF的ROC曲线下面积为0.940,以STAF评分≥5分作为最佳截断点,STAF评分的灵敏度与特异度分别为91.89%、87.16%。LADS评分诊断AF的ROC曲线下面积为0.844,以LADS评分≥4分作为最佳截断点,LADS评分的灵敏度与特异度分别为71.62%、87.16%。ROC曲线下面积STAF评分大于LADS评分,二者间有明显差异（P〈0.005）。结论 STAF评分及LADS评分对急性缺血性脑卒中患者是否合并AF具有较好的预测价值,且STAF较LADS评分准确性更高。Objective To study the value of STAF（score for the targeting of atrial fibrillation）and LADS（1eft atrial diameter,age,diagnosis of stroke or TIA,smoking）for screening atrial fibrillation（AF）in patients with acute ischemic stroke in China.Methods 331 consecutive patients with acute ischemic stroke referred to our department between Dec,2013 and Dec,2014 were enrolled,and the demographic information,the first-time National Institute of Health Stroke Scale（NIHSS）score after permission and the results of the vascular assessment of head and neck were collected.Every patient was evaluated by STAF score and LADS score respectively.Then according to the results,the receiver operator characteristic（ROC）curve to ascertain the optimal cutoff to screen AF was drew.At last,the sensitivity and specificity of STAF score and LADS score was calculated respectively,and the comparison of diagnostic accuracy between them was made.Results A total of 331 patients were collected,there were 211 males and 120 females,the age ranged from31 years to 92 years,averaged（64±3.5）years.The area under the ROC curve of STAF score to screen AF was0.940.The sensitivity and specificity of the STAF score were 91.89% and 87.16%respectively when the optimal cutoff was 5.The area under the ROC curve of LADS score to screen AF was 0.844.The sensitivity and specificity of the STAF score were 71.62% and 87.16%respectively when the optimal cutoff was 4.The area under the ROC curve of STAF is larger than LADS and they had significant difference（P 0.005）.Conclusion STAF score and LADS score are both suitable for Chinese population,they had a good screening value for atrial fibrillation in patients with acute ischemic stroke.Meanwhile,STAF score is better than LADS score in accuracy.

关 键 词：STAF评分 LADS评分 急性缺血性脑卒中 心房颤动 

分 类 号：R749.1[医药卫生—神经病学与精神病学]