他汀类药物对新发房颤的治疗效果与CHADS2评分的关系分析

Relationship between CHADS2 score and statins for the treatment of new-onset atrial fibrillation

目的 探讨CHADS2评分与新发房颤是否存在关系,及CHADS2评分是否可以运用到他汀类药物对急性心肌梗死患者心律失常的预防.方法 选取213例急性心肌梗死患者,根据CHADS2评分分为3组,其中A组61例患者的CHADS2评分为0分,B组83例患者的CHADS2评分为1-2分,C组69例患者的CHADS2评分为3-6分.对所有患者均使用他汀类和非他汀类药物治疗,观察他汀类药物的治疗效果与CHADS2评分之间的关系.结果 CHADS2评分越高的急性心肌梗死患者的新发房颤发病率越高（P＜0.05）;CHADS2评分≤2的急性心肌梗死患者服用他汀类药物后,新发房颤的发病率远低于未服用他汀类药物的患者（P＜0.05）,而CHADS2评分≥3的患者中,他汀类药物则不存在此效果（P ＞0.05）;CHADS2评分≤2的急性心肌梗死患者服用他汀类药物后,C反应蛋白的水平远低于未服用他汀类药物的患者（P＜0.05）,而CHADS2评分≥3的患者中,他汀类药物则不存在此效果（P＞0.05）.结论 CHADS2评分能够很好地预测新发房颤的发病率,并且其还能很好地评价他汀类药物对急性心肌梗死心律失常患者的预防效果.

Objective To investigate the relationship between CHADS2 score and new-onset atrial fibrillation, and whether the CHADS2 score can be applied to evaluate the preventive effect of statins on the arrhythrnia of acute myocardial infarction. Methods 213 cases of acute myocardial infarction patients were selected and divided into 3 groups according to CHADS2 score. Group A had 61 patients with CHADS2 score of 0 point,group B had 83 cases of patients with CHADS2 score of 1 - 2 point, group C had 69 patients with CHADS2 score of 3 - 6 point. All patients were treated with statin and nonstain, and the relationship between the therapeutic effect of statin and CHADS2 score was observed. Results The higher was CHADS2 score in patients with acute myocardial infarction, the higher was the incidence of new onset atrial fibrillation（ P 〈0. 05 ） ;after taking statins ,the incidence of new-onset atrial fibrillation of acute myocardial infarction patients with CHADS2 score was less than or equal to 2, far lower than patients without taking statins（P 〈0. 05） ;neither the patients with CHADS2 score greater than or equal to 3 taking statins,nor the effect had significant difference（ P 〈 0.05 ） ;after taking statins, the C-reactive protein levels of acute myocardial infarction patients with CHADS2 score was less than or equal to 2, far lower than the patients without taking statins （ P 〈 0. 05 ） ; while the patients with CHADS2 score greater than or equal to 3 had no similar result （ P 〉 0.05 ）. Conclusion CHADS2 score can predict the incidence of new-onset atrial fibrillation, and it is also a good evaluation of statins in cu- ring acute myocardial infarction patients with arrhythmias.