CHA2DS2-VASc评分联合左房超声指标对非瓣膜性心房颤动患者发生缺血性卒中风险的预测价值  

Predictive value of CHA2DS2-VASc score combined with leftatrial ultrasound indexes for the risk of ischemic stroke in patients with non-valvular atrial fibrillation

作　　者：程晓歌 商丽华 Cheng Xiaoge;Shang Lihua(Zhengzhou Cardiovascular Hospital/Zhengzhou Seventh People's Hospital(Henan Key Laboratory of Arrhythmia Medicine),Zhengzhou,Henan 450016,China;Department of Cardiology,The First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]郑州市心血管病医院/郑州市第七人民医院(河南省心律失常医学重点实验室),河南郑州450016 [2]清华大学第一附属医院心内科,北京100016

出　　处：《现代临床医学》2025年第2期88-91,共4页Journal of Modern Clinical Medicine

摘　　要：目的:探讨CHA2DS2-VASc评分联合左房超声指标对非瓣膜性心房颤动患者发生缺血性卒中风险的预测价值。方法:纳入2020年6月至2021年2月在清华大学第一附属医院心内科及神经内科住院的41例非瓣膜性心房颤动患者,根据有无合并缺血性卒中将患者分为卒中组(24例)及非卒中组(17例),测量并比较两组患者的容积指数、排空分数、收缩期应变及应变率等左房超声指标。结果:卒中组收缩期左房应变率低于非卒中组(P<0.05);CHA_2DS_2-VASc评分及其联合收缩期左房应变率预测心房颤动患者卒中风险的ROC曲线下面积分别为0.691、0.745(P<0.05)。结论:与单独采用CHA2DS2-VASc评分相比,在该评分基础上联合收缩期左房应变率,对非瓣膜性心房颤动患者发生缺血性卒中风险的预测价值更高。Objective:To explore the predictive value of CHA2DS2-VASc score combined with left atrial ultrasound indexes for the risk of ischemic stroke in patients with non-valvular atrial fibrillation.Methods:A total of 41 patients with non-valvular atrial fibrillation who were hospitalized in the Department of Cardiology or Department of Neurology of The First Affiliated Hospital of Tsinghua University from June 2020 to February 2021 were included.According to the presence or absence of concomitant ischemic stroke,the patients were divided into the stroke group(n=24)and the non-stroke group(n=17).The left atrial ultrasound indexes such as volume index,ejection fraction,systolic strain and strain rate were measured and compared between the two groups.Results:The peak left atrial strain rate during reservoir phase(pLASRr)in the stroke group was lower than that in the non-stroke group(P<0.05);the areas under the ROC curves of the CHA2DS2-VASc score and its combination with the left atrial systolic strain rate for predicting the stroke risk in patients with atrial fibrillation were 0.691 and 0.745,respectively(P<0.05).Conclusion:Compared with the sole use of the CHA2DS2-VASc score,the combination of the CHA2DS2-VASc score and pLASRr has a higher predictive value for the risk of ischemic stroke in patients with non-valvular atrial fibrillation.

关 键 词：心房颤动 收缩期左房应变率 缺血性卒中 心脏超声 

分 类 号：R541[医药卫生—心血管疾病]