CHA2DS2-VASc评分联合血浆脂蛋白相关磷脂酶A2水平预测非瓣膜病心房颤动患者脑梗死风险的研究

The study of CHA2DS2-VASc score combined with plasma lipoprotein-associated phospholipase A2 levels predicting the risk of ischemic stroke in patients with non-valvular atrial fibrillation

目的探讨CHA2DS2-VASc评分联合血浆脂蛋白相关磷脂酶A2水平(Lp-PLA2)对非瓣膜病心房颤动(NVAF)患者脑梗死风险的预测价值。方法入选广州医科大学附属惠州医院住院的242例NVAF患者,记录入院时血浆Lp-PLA2水平,计算CHA2DS2-VASc评分。出院后每3个月随访1次,随访期间发生缺血性脑卒中或随访满1a随访结束,根据随访结果分为脑梗死组和非脑脑梗死组。结果脑梗死组CHA2DS2-VASc评分、Lp-PLA2水平比非脑梗死组偏高。经Logistic回归分析证实,高CHA2DS2-VASc评分、高Lp-PLA2水平为NVAF患者发生脑梗死的危险因素。CHA2DS2-VASc评分、Lp-PLA2水平、CHA2DS2-VASc评分联合Lp-PLA2水平预测NVAF患者发生脑梗死的受试者工作特征(ROC)曲线下面积分别为0.815、0.796、0.879。结论 CHA2DS2-VASc评分联合Lp-PLA2水平可提高对NVAF患者发生脑梗死风险的预测价值。

Objective To explore the predictive value of CHA2DS2- VASc score combined with plasma lipoproteinassociated phospholipase A2 （Lp-PLA2） levels for the risk of ischemic stroke in patients with non-valvular atrial fibrillation （NVAF）. Methods 242 patients with NVAF that were in Affiliated Huizhou Hospital of Guangzhou Medical University were se tected, the admission Lp-PLA2 levels was recorded, and CHA2DS2-VASc 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. Results The CHA2DS2-VASc score, Lp-PLA2 levels of the patient in the stroke group were higher than that in the non-stroke group. The high CHA2DS2-VASc score and high Lp-PLA2 levels were independent risk factors of ischemic stroke in patients with NVAF by logistic regression analysis. The area under the ROC curve of CHA2DS2-VASc score, Lp-PLA2 levels and CHA2DS2-VASc score combined with Lp-PLA2 levels were 0. 815,0. 796,0. 895 to predict the happening of ischemic stroke in patients with NVAF. Conclusion CHA2DS2-VASc score combined with Lp-PLA2 levels may improve the predictive value of the risk of ischemic stroke in patients with NVAF.