CHA_2DS_2-VASc评分对冠状动脉病变严重程度的预测价值

Predictive value of CHA_2DS_2-VASc score for severity of coronary artery disease

目的探讨冠脉病变严重程度的危险因素及CHA_2DS_2-VASc评分法对冠脉病变严重程度的预测价值。方法回顾性选取2017年1-11月于盛京医院第一心血管内科完善冠状动脉造影的477例患者,分别计算每例患者CHA_2DS_2-VASc评分与SYNTAX评分,根据SYNTAX评分将患者分为轻(n=384)、中(n=62)、重度病变(n=31)3组,记录3组的各项生化指标并采用多元Logistic回归分析患者冠状动脉病变严重程度的危险因素,应用Spearman相关分析评估CHA_2DS_2-VASc评分与冠脉病变严重程度的关系。结果年龄[OR为1.031,95%CI(1.002～1.062),P=0.039]、结合胆红素[OR为1.191,95%CI(1.059～1.340),P=0.004]、肌酸激酶同工酶[OR为1.005,95%CI(1.001～1.008),P=0.008]及CHA_2DS_2-VASc评分[OR为1.568,95%CI(1.294～1.899),P <0.001]是冠状动脉病变严重程度的独立危险因素;患者CHA_2DS_2-VASc评分与SYNTAX评分呈正相关(r=0.462,P <0.001)。结论年龄、结合胆红素、肌酸激酶同工酶及CHA_2DS_2-VASc评分是冠脉病变严重程度的独立危险因素,CHA_2DS_2-VASc评分与SYNTAX评分结果呈正相关关系,其对临床冠状动脉病变严重程度有一定的预测价值。

Objective To investigate the predictive value of CHA2DS2-VASc score and the risk factors for severity of coronary artery lesions.Methods A total of 477 consecutively admitted patients who underwent cor-onary angiography from January 2017 to November 2017 were enrolled.We calculated the CHA2DS2-VASc score and the SYNTAX score,dividing the patients into 3 groups including mild lesion group(n=384),moderate lesion group(n=62)and severe lesion group(n=31)according to SYNTAX Score.The biochemical indexes of the patients in the 3 groups were measured and identified the relationship of CHA2DS2-VASc score and severity of coronary artery lesions,as well as the risk factors of severity of coronary artery lesions.Results Age[OR=1.031,95%CI(1.002~1.062),P=0.039],BilD[OR=1.191,95%CI(1.059~1.340),P=0.004],CKMB[OR=1.005,95%CI(1.001~1.008),P=0.008]and CHA2DS2-VASc score[OR=1.568,95%CI(1.294~1.899),P<0.001]were the independent risk factors for severity of coronary artery lesions.The CHA2DS2-VASc score was positively correlated to the severity of coronary artery lesions(r=0.462,P<0.001).Conclusions Age,BilD,CKMB and CHA2DS2-VASc score are the independent risk factors for severity of coronary artery lesions.CHA2DS2-VASc score is positively correlated with SYNTAX score,and it predicts the severity of coronary artery lesions.