CHA_(2)DS_(2)-VASc-RAF评分对非瓣膜病心房颤动患者左心房血栓的预测价值  

Predictive value of CHA_(2)DS_(2)-VASc-RAF score for left atrial thrombus in patients with non-valvular atrial fibrillation

作　　者：孙萍[1] 郭志浩 杨建国[1] 赵明[1] 孙洁 寿璋 SUN Ping;GUO Zhi-hao;YANG Jian-guo;ZHAO Ming;SUN Jie;SHOU Zhang(The Third Vasculocardiology Department,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China;The Sixth Vasculocardiology Department,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院心血管内三科,沧州061000 [2]沧州市中心医院心血管内六科,沧州061000

出　　处：《岭南心血管病杂志》2021年第5期547-551,共5页South China Journal of Cardiovascular Diseases

基　　金：沧州市科学技术研究与发展指导计划项目(项目编号:162302151)。

摘　　要：目的探讨一种改进的CHA2DS2-VASc-RAF评分对非瓣膜病心房颤动(non-valvul aratrial fibrillation,NVAF)患者左心房血栓形成的预测价值。方法回顾性分析2017年1月至2020年1月沧州市中心医院经食管超声心动图检查的237例NVAF患者资料,采用相关性分析、Logistic回归分析和受试者工作特征(receiver operating characteristic,ROC)曲线评价CHA2DS2-VASc-RAF评分对左心房血栓形成的预测价值。结果NVAF患者左心房血栓的发生率为9.28%。相关性分析显示,CHA2DS2-VASc-RAF评分与NVAF患者左心房血栓形成呈正相关(r=0.402;P<0.001)。多因素Logistic回归分析显示,CHA2DS2-VASc-RAF评分为左心房血栓形成的独立危险因素(P=0.041)。ROC曲线分析显示,CHA2DS2-VASc-RAF评分预测左心房血栓形成的曲线下面积为0.895(95%CI:0.811~0.979,P<0.001),敏感度为86.4%,特异度为82.3%。Hanley&McNeil法进行两两比较显示,CHA2DS2-VASc-RAF的预测价值优于CHA2DS2-VASc(Z=2.151,P=0.032)。结论CHA2DS2-VASc-RAF评分能够有效预测NVAF患者左心房血栓的形成。Objectives To determine the predictive value of an improved CHA2DS2-VASc-RAF score as a predictor for left atrial thrombus in patients with non-valvular atrial fibrillation(NVAF).Methods Data of 237 patients with NVAF undergoing transesophageal echocardiograph from January 2017 to January 2020 in Cangzhou Central Hospital were enrolled in this retrospective study.The correlation analysis,Logistic regression analysis and receiver operating characteristic(ROC)curve were used to evaluate the predictive value of CHA2DS2-VASc-RAF score in detecting left atrial thrombus.Results The prevalence of left atrial thrombus in patients with NVAF was 9.28%.The correlation analysis showed that CHA2DS2-VASc-RAF score was positively correlated with left atrial thrombus in patients with NVAF(r=0.402,P<0.001).Multivariate Logistic regression analysis indicated that CHA2DS2-VASc-RAF score was an independent risk factor of left atrial thrombus(P=0.041).The ROC curve of CHA2DS2-VASc-RAF scores revealed an area under curve was 0.895(95%CI:0.811~0.979,P<0.001),with 86.4%of sensibility and 82.3%of specificity.Comparison of the ROC curves by Hanley&McNeil method showed that CHA2DS2-VASc-RAF score was higher in predictive value than CHA2DS2-VASc score.Conclusions CHA2DS2-VASc-RAF score is a predictor for left atrial thrombus in patients with NVAF.

关 键 词：心房颤动 CHA_(2)DS_(2)-VASc-RAF 左心房血栓 预测 

分 类 号：R541.7[医药卫生—心血管疾病]