CHA2DS2-VASc-HSF评分与冠心病及其严重程度的相关性研究

Correlation between CHA_2DS_2-VASc-HSF scores and severity of coronary heart disease

目的探讨CHA2DS2-VASc-HSF评分对冠状动脉粥样硬化性心脏病(冠心病)及其严重程度的预测价值。方法选取2016年1月～2017年12月于武汉大学人民医院行冠状动脉(冠脉)造影的病例202例,根据造影结果分为冠心病组(n=166)、对照组(n=36)。根据冠脉病变支数将冠心病组分为单支病变组(n=47)、双支病变组(n=63)、多支病变组(n=56)。计算每例患者的CHA2DS2-VASc、CHA2DS2-VASc-HSF评分及Gensini积分,分析这两种评分与冠脉病变程度的相关性。结果 CHA2DS2-VASc评分与病变支数及Gensini积分呈正相关(r=0.606,P<0.001;r=0.723,P<0.001),CHA2DS2-VASc-HSF评分与病变支数及Gensini积分呈正相关(r=0.612,P<0.001;r=0.801,P<0.001)。截断点分析示:CHA2DS2-VASc-HSF≥3分对冠心病的预测价值最好[灵敏度0.792,特异度0.903,曲线下面积0.931(95%CI:0.896～0.966)]。结论 CHA2DS2-VASc-HSF评分对冠心病有较好的预测价值,它可能作为预测模型发挥重要作用。

Objective To discuss the predictive value of CHA2DS2-VASc-HSF scores to coronary heart disease(CHD)and severity of CHD.Methods The patients(n=202)undergone coronary angiography(CAG)were chosen from Renmin Hospital of Wuhan University from Jan.2016to Dec.2017,and then divided into CHD group(n=166)and control group(n=36)according to CAG results.The CHD group were again divided into1-vessel lesion group(n=47),2-vessel lesion group(n=63)and multi-vessel lesion group(n=56).The scores of CHA2DS2-VASc and CHA2DS2-VASc-HSF,and Gensini integrals were calculated in all patients,and correlation among these scores,integrals and severity of coronary artery lesions.Results CHA2DS2-VASc scores were positively correlated to number of lesion vessels(r=0.606,P<0.001)and Gensini integrals(r=0.723,P<0.001).CHA2DS2-VASc-HSF scores were positively correlated to number of lesion vessels(r=0.612,P<0.001)and Gensini integrals(r=0.801,P<0.001).The results of cut-off point analysis showed that when CHA2DS2-VASc-HSF score was≥3,the predictive value to CHD was the highest[sensitivity was0.792,specificity was0.903and AUC was0.931(95%CI:0.896~0.966)].Conclusion CHA2DS2-VASc-HSF scores have higher predictive value to CHD.It may play an important role as predictive model.