摘要
目的探讨CHADS2评分联合红细胞分布宽度(red blood cell distribution width,RDW)对非瓣膜病心房颤动患者缺血性脑卒中风险的预测价值。方法入选于本院住院的230例非瓣膜病心房颤动患者,记录患者入院时的RDW,为每位患者计算CHADS2评分。患者出院后每3个月随访1次,患者随访期间发生缺血性脑卒中或随访满1年则随访结束,根据随访结果将患者分为脑卒中组和非脑卒中组。结果脑卒中组患者的CHADS2评分、RDW、中性/淋巴细胞比非脑卒中组患者偏高,肾小球滤过率较非脑卒中组患者偏低。经logistic回归分析证实,高CHADS2评分、高RDW为非瓣膜病心房颤动患者发生缺血性脑卒中的危险因素。CHADS2评分、RDW、CHADS2评分联合RDW预测非瓣膜病心房颤动患者发生缺血性脑卒中的受试者工作特征(receiver operating characteristic curve,ROC)曲线下面积分别为0.781、0.758、0.842。结论将CHADS2评分与RDW联合可提高对非瓣膜病心房颤动患者发生缺血性脑卒中风险的预测价值。
Objective To explore the predictive value of CHADS2 score combined with red blood cell distribution width（RDW） for the risk of ischemic stroke in patients with non-valvular atrial fibrillation（NVAF）. Method 230 patients with NVAF that were in Baoding No. 1 Central Hospital were selected, the admission RDW was recorded, and CHADS2 score was calculated for each patient. The patients were seen for follow-up visits once every three months after they discharged from hospital, the follow-up visit finished when the patient suffered ischemic stroke or the patient was followed up for 1 year. They were divided into stroke group and non-stroke group according to the follow-up result. Result The CHADS2 score, RDW, neutrophil/lymphocyte ratio of the patient in the stroke group were higher than that in the non-stroke group. The estimated glomerular filtration rate （ e-GFR） of the patient in the stroke group was lower than that in the non-stroke group. The high CHADS2 score and high RDW were independent risk factors of ischemic stroke in patients with NVAF by logistic regression analysis. The area under the ROC curve of CHADS2 score, RDW and CHADS2 score combined with RDW were 0. 781, 0. 758, 0. 842 to predict the happen-ing of ischemic stroke in patients with NVAF. Conclusion CHADS2 score combined with RDW may improve the predictive value of the risk of ischemic stroke in patients with NVAF.
出处
《中国医刊》
CAS
2015年第8期43-46,共4页
Chinese Journal of Medicine
