CHADS2评分对房颤患者血管性痴呆的预测价值

Prediction value of CHADS2 score in vascular dementia in patients with atrial fibrillation or atrial flutter

目的评估CHADS2评分是否可作为房颤患者血管性痴呆发生风险分层的有用指标。方法从2010年9月-2013年12月在南方医科大学附属普宁华侨医院共纳入776例房颤的患者,随访记录发展成为血管性痴呆的患者,评估CHADS2评分与血管性痴呆的关系。结果共发现65例患者发生血管性痴呆,发生血管性痴呆的患者年龄较大,并且高血压病、糖尿病、脑卒中和慢性肾病的发病率较高;发生血管性痴呆的患者的BMI值和收缩压显著高于未发生血管性痴呆的患者;CHADS2评分越高,将来患者发展成血管性痴呆的比例越高,风险越大;在多变量分析中CHADS2评分是血管性痴呆发生的独立危险因素(风险比1.64,95%置信区间1.21~1.79,P=0.009)。结论 CHADS2评分是房颤患者血管性痴呆发病的有用预测指标。

Objective To assess whether the CHADS2 score could be used as a useful parameter of the risk stratification of vascular dementia in patients with atrial fibrillation. Methods From September 2010 to December 2013, 776 patients with atrial fibrillation were enrolled in Puning Overseas Chinese Hospital Affiliated to Southern Medical University. Patients who developed vascular dementia were followed up to assess the relationship between CHADS2 score and vascular dementia. Results A total of 65 patients with vascular dementia were diagnosed. Patients with vascular dementia were older, and the incidence of hypertension, diabetes, stroke, and chronic kidney disease were higher, and the BMI and Systolic blood pressure levels of patients with vascular dementia were significantly higher than those of patients without dementia. The higher the CHADS2 score, the higher the proportion of patients developing vascular dementia in the future, and the greater the risk it was. In the multivariate analysis, the CHADS2 score was an independent parameter for the risk of vascular dementia(hazard ratio 1.64, 95% confidence interval 1.21~1.79, P=0.009). Conclusion The CHADS2 score was a useful parameter of vascular dementia in patients with atrial fibrillation.