非瓣膜性房颤合并急性缺血性脑卒中危险因素分析及临床风险评估

Risk factors analysis and clinical risk assessment of atrial fibrillation-related stroke

目的分析非瓣膜性房颤合并急性缺血性脑卒中的危险因素,并进行临床风险预测评估。方法回顾性分析2019年1月1日-2021年3月31日期间于新疆医科大学第一附属医院就诊的199例非瓣膜性房颤(NVAF)患者临床资料,其中98例合并急性缺血性脑卒中患者作为病例组,余101例单纯NVAF患者作为对照组。收集两组入院时一般临床资料及血液生化指标,计算CHA2DS2-VASc评分。对两组危险因素行单因素及Logistic回归分析,对有意义的危险因素联合CHA2DS2-VASc评分对其发生急性缺血性脑卒中的风险进行评估。结果年龄、糖尿病、脉压、中性粒细胞/淋巴细胞比值(NLR)与非瓣膜性房颤患者发生急性缺血性脑卒中有相关关系(P<0.05),与CHA2DS2-VASc评分相比,NLR联合CHA2DS2-VASc评分ROC曲线下面积增加0.118(P<0.05)。结论NLR联合CHA2DS2-VASc评分可增加非瓣膜性房颤患者发生急性缺血性脑卒中的预测价值。

Objective To analyze the risk factors of non-valvular atrial fibrillation complicated with acute ischemic stroke,and to predict and evaluate the clinical risks.Methods The clinical data of 199 patients with non-valvular atrial fibrillation admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1,2019 to March 31,2021 were retrospectively analyzed.According to the presence or absence of acute ischemic stroke,they were divided into two groups:atrial fibrillation with acute ischemic stroke group(n=98)and simple non-valvular atrial fibrillation control group(n=101).General clinical data and blood biochemical indexes were collected at admission,and CHA2DS2-VASc score was calculated.Univariate and logistic regression analysis were used to analyze the related factors of the two groups.The risk of acute cerebral infarction was evaluated by the significant blood related risk factors combined with CHA2DS2-VASc score.Results Age,diabets,pulse pressure and NLR were correlated with acute cerebral infarction in patients with non-valvular atrial fibrillation(P<0.05),and the area under ROC curve of combined index increased by 0.118(P<0.05).Conclusion NLR combined with CHA2DS2-VASc score can improve the predictive value of acute ischemic stroke risk in patients with non-valvular atrial fibrillation.