血清胱抑素c与非瓣膜性房颤患者CHA2DS2-VASc评分的相关性

Relationship of cystatin c and CHA2DS2-VASc score in non-valvular atrial fibrillation patients

目的:探讨血清胱抑素c(CYS-c)与评估非瓣膜性房颤患者发生缺血性脑卒中风险的CHA2DS2-VASc评分的相关性。方法:连续入选非瓣膜性房颤患者99例(其中阵发房颤患者51例,持续房颤患者22例,永久性房颤患者26例),根据患者CHA2DS2-VASc评分,分为中低危组(CHA2DS2-VASc<2分者),高危组(CHA2DS2-VASc≥2分者),记录所有患者临床资料、实验室检查结果及超声心动图结果,比较两组各项指标的差异,同时探讨房颤患者血清胱抑素c与CHA2DS2-VASc评分的关系。结果:高危组的年龄、女性比例及伴有高血压、糖尿病、心力衰竭史、脑卒中史比例较中低危组显著升高,差异有统计学意义(P<0.05)。与中低危组相比,高危组患者血清胱抑素c、左房直径、中性粒淋巴细胞比值显著升高,差异有统计学意义(P<0.05)。多变量Logistic回归分析显示胱抑素c是房颤患者CHA2DS2-VASc的独立预测因素(P<0.05)。预测CHA2DS2-VASc高分的胱抑素c的ROC曲线下面积为0.722(95%CI:0.604-0.839,P<0.05)。结论:血清胱抑素c是非瓣膜性房颤患者CHA2DS2-VASc评分的独立预测因子,对房颤脑卒中风险评估有参考意义。

Objective： To investigate the relationship between cystatin c（CYS-c） and CHA2DS2-VASc score for the evaluation of thromboembolism risk in patients with non-valvular atrial fibrillation（AF）. Methods： Ninety-nine patients with AF（51 with paroxysmal AF,22 with persistent AF and 26 with permanent AF） were collected in this study. According to CHA2DS2-VASc score, the AF patients were divided into low-intermediate risk group（CHA2DS2-VASc〈2） and high risk group（CHA2DS2-VASc≥2）. The clinical data, laboratory parameters and echocardiography were detected and then the parameters between the two groups were compared to evaluate the relationship between CYS-c and CHA2DS2-VASc score in patients with AF. Results： The basic characteristics between the two groups had significant differences in sex, age, and comorbidities. High CHA2DS2-VASc score group had higher CYS-c, left atrial diameter,and neutrophil lymphocyte ratio,when compared with the low CHA2DS2-VASc score group.The multivariate logistic regression analysis was performed to predict high CHA2DS2-VASc scores.The result revealed that CYS-c was an independent predictor（P〈0.05）. The area below the receiver-operating characteristic curve of CYS-c was 0.722（95%CI：0.604-0.839, P〈0.05） for predicting high CHA2DS2-VASc score.Conclusion：CYS-c is an independent predictor for high CHA2DS2-VASc score and might provide some indications for the evaluation of thromboembolism.