CHADS2评分在不同冠脉病变严重程度的非房颤患者中发生卒中的预防意义  

Value of CHADS2 score to predict the incidence of stroke in patients of differently severity coronary artery disease without atrial fibrillation

作　　者：刘员员[1] 洪浪[1] 

机构地区：[1]江西省人民医院心内科,江西南昌330000

出　　处：《安徽医药》2016年第5期907-910,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨CHADS2评分指导非房颤的不同冠脉病变严重程度患者卒中的预防意义。方法回顾性分析非房颤的冠心病患者211例，并按CHADS2评分分别分为三组：0～1分（A组）78例、2分（B组）70例、3～6分（C组）63例，并分别按Gensini评分分为两组：A组（≤20分组）68例、（〉20分组）10例；B组（≤20分组）4S例、（〉20分组）22例；C组（≤20分组）20例、（〉20分组）43例；且随访所有患者出现卒中情况。结果B组、C组比A组患者Gensini评分更可能〉20分，差异有统计学意义（P〈0．01），C组与B组患者比较Gensini评分更可能〉20分，差异有统计学意义（P〈0．01），余非房颤的冠心病患者随访期间出现卒中的52例，C组与A组、B组比较发生卒中的概率更大，差异有统计学意义（P〈0．01）；B组与A组比较发生卒中的概率无明显差异，差异无统计学意义（P〉0．05）；且CHADS2评分分组对卒中的影响比较，以卒中为因变量，以CHADS2评分0～1分为对照组，CHADS2评分3～6分组比CHADS2评分0～1分组发生卒中的可能性大，OR值2．068（95％CI为1．375～3．674），提示CHADS2评分3～6分组发生卒中的可能性是CHADS2评分0～1分组2．068倍。结论CHADS2评分是非房颤的不同冠脉病变程度的患者是否发生卒中的独立预测危险因素，为冠心病患者更早的联用抗凝药物的治疗提供依据。Objectives To discuss the value of CHADS2 score to predict the incidence of stroke in patients of differently severity coronary artery disease without atrial fibrillation. Methods To retrospectively analysis 211 cases,According to CHADS2 score,The patients were divided into three groups: 0 and 1 group( 78 cases)( group A),2 group( 70 cases)( group B),3 ~ 6 group( 63 cases)( group C),and According to the Gensini score,Every group was respectively divided into two groups: group A( ≤20 group) 68 cases and( >20 group) 10 cases); Group B( ≤20 group) 48 cases,( > 20 group) 22 cases); Group C( ≤20 group) 20 cases,( > 20 group) 43cases); then follow-up the incidence of stroke with all patients. Results Gensini score of group C and group B compared with that of group A are more likely to higher than 20 points,the difference was statistically significant( P < 0. 01),Gensini score of group C compared with that of group B are more likely to higher than 20 points,the difference was statistically significant( P < 0. 01),52 cases of all the patients have stroke during the period of follow-up. group C compared with group A and group B had higher probability of stroke,the difference was statistically significant( P < 0. 01); Probability of stroke between group B and group A has not obvious difference,the difference was not statistically significant( P > 0. 05),and the CHADS2 score was independent risk factor of stroke in the patients of differently severity coronary artery disease without atrial fibrillation,CHADS2 score 0 ~ 1 was divided into control group,CHADS2 score3 to 6 group compared with CHADS2 score 0 ~ 1 group was higher the possibility of stroke,OR was 2. 068( 95% CI 1. 375 ~ 3. 674),the possibility of stroke in CHADS2 score 3 to 6 group was 2. 068 times than the possibility of stroke in CHADS2 score 0 ~ 1 group. Conclusion The CHADS2 score was independent risk factor of stroke in the patients of differently severity coronary artery disease without atrial fibrilliation to provide the reference opinion for the tre

关 键 词：冠心病/并发症 卒中 创伤严重度指数 CHADS评分 

分 类 号：R541.75[医药卫生—心血管疾病] R743.3[医药卫生—内科学]