临床神经病学杂志
臨床神經病學雜誌
림상신경병학잡지
JOURNAL OF CLINICAL NEUROLOGY
2014年
3期
189-192
,共4页
杨帆%关珂%孙林琳%司承庆%潘玉君
楊帆%關珂%孫林琳%司承慶%潘玉君
양범%관가%손림림%사승경%반옥군
脑梗死%心房纤颤%预后%CHA2DS2-VASc评分
腦梗死%心房纖顫%預後%CHA2DS2-VASc評分
뇌경사%심방섬전%예후%CHA2DS2-VASc평분
cerebral infarction%atrial fibrillation%prognosis%CHA2DS2-VASc score
目的：探讨伴非瓣膜性心房纤颤（房颤）的急性脑梗死患者的短期预后及其相关因素。方法调查197例伴有房颤的急性脑梗死患者的临床资料，并进行CHA2DS2-VASc评分。在发病后3个月时，采用改良Rankin量表（mRS）评定患者的预后。比较预后良好与预后不佳患者的临床资料和CHA2DS2-VASc评分，对有统计学意义的因素行 Logistic 回归分析。结果本组患者中189例（95．4％）的 CHA2DS2-VASc评分＞1分。预后良好93例（47．2％），预后欠佳104例（52.8％），仅抗凝达标组患者预后的差异有统计学意义（P＜0.05）。预后良好与预后欠佳患者的年龄、性别、卒中史、美国国立卫生研究院卒中量表（NIHSS）评分、抗凝达标及CHA2DS2-VASc评分的差异有统计学意义（P＜0.05～0．01）。多因素Logistic回归分析显示， NIHSS评分、CHA2DS2-VASc评分（OR＝1．32，95％CI：1．16～1．51，P＝0.002）和标准的抗凝治疗（OR＝0．49，95％CI：0．28～0．89，P＝0.018）为预后的独立预测因素。结论伴有房颤的急性脑梗死患者短期预后欠佳， NIHSS评分、CHA2DS2-VASc评分和抗凝达标是短期预后的独立预测因素。
目的：探討伴非瓣膜性心房纖顫（房顫）的急性腦梗死患者的短期預後及其相關因素。方法調查197例伴有房顫的急性腦梗死患者的臨床資料，併進行CHA2DS2-VASc評分。在髮病後3箇月時，採用改良Rankin量錶（mRS）評定患者的預後。比較預後良好與預後不佳患者的臨床資料和CHA2DS2-VASc評分，對有統計學意義的因素行 Logistic 迴歸分析。結果本組患者中189例（95．4％）的 CHA2DS2-VASc評分＞1分。預後良好93例（47．2％），預後欠佳104例（52.8％），僅抗凝達標組患者預後的差異有統計學意義（P＜0.05）。預後良好與預後欠佳患者的年齡、性彆、卒中史、美國國立衛生研究院卒中量錶（NIHSS）評分、抗凝達標及CHA2DS2-VASc評分的差異有統計學意義（P＜0.05～0．01）。多因素Logistic迴歸分析顯示， NIHSS評分、CHA2DS2-VASc評分（OR＝1．32，95％CI：1．16～1．51，P＝0.002）和標準的抗凝治療（OR＝0．49，95％CI：0．28～0．89，P＝0.018）為預後的獨立預測因素。結論伴有房顫的急性腦梗死患者短期預後欠佳， NIHSS評分、CHA2DS2-VASc評分和抗凝達標是短期預後的獨立預測因素。
목적：탐토반비판막성심방섬전（방전）적급성뇌경사환자적단기예후급기상관인소。방법조사197례반유방전적급성뇌경사환자적림상자료，병진행CHA2DS2-VASc평분。재발병후3개월시，채용개량Rankin량표（mRS）평정환자적예후。비교예후량호여예후불가환자적림상자료화CHA2DS2-VASc평분，대유통계학의의적인소행 Logistic 회귀분석。결과본조환자중189례（95．4％）적 CHA2DS2-VASc평분＞1분。예후량호93례（47．2％），예후흠가104례（52.8％），부항응체표조환자예후적차이유통계학의의（P＜0.05）。예후량호여예후흠가환자적년령、성별、졸중사、미국국립위생연구원졸중량표（NIHSS）평분、항응체표급CHA2DS2-VASc평분적차이유통계학의의（P＜0.05～0．01）。다인소Logistic회귀분석현시， NIHSS평분、CHA2DS2-VASc평분（OR＝1．32，95％CI：1．16～1．51，P＝0.002）화표준적항응치료（OR＝0．49，95％CI：0．28～0．89，P＝0.018）위예후적독립예측인소。결론반유방전적급성뇌경사환자단기예후흠가， NIHSS평분、CHA2DS2-VASc평분화항응체표시단기예후적독립예측인소。
Objective To explore the short-term prognosis and its correlated factors in acute cerebral infarction patients with nonvalular atrial fibrillation .Methods The clinical data of 197 acute cerebral infarction patients with atrial fibrillation were investigated .The CHA2DS2-VASc score was calculated .And recovery was assessed by modified Rankin Scale(mRS) at 3 months follow-up.The clinical data and CHA2DS2-VASc score were compared between good prognosis and poor outcome in patients .Variables that reached statistical significance were analyzed using logistic regression analysis .Results One hundred and eighty-nine(95.4%) patients had a CHA2DS2-VASc score >1.Good prognosis and poor outcome were found in 93(47.2%) and 104(52.8%)patients respectively. Only the difference of prognosis in therapeutic anticoagulation group reached statistical significance (P<0.05).The differences between good prognosis and poor outcome in age , sex, previous stroke ,National Institute of Health stroke scale(NIHSS) score, antithrombotic treatment and CHA2DS2-VASc score were statistical significant (P<0.05 -0.001).Multivariate logistic regression model results suggested that NIHSS score ,CHA2DS2-VASc score (OR =1.32,95%CI:1.16 -1.51,P=0.002) and therapeutic anticoagulation (OR=0.49,95%CI:0.28 -0.89,P=0.018) were independent predictors of stroke prognosis .Conclusion The short-term prognosis in acute cerebral infarction patients with nonvalular atrial fibrillation is not so good , and the NIHSS score, CHA2DS2-VASc score and therapeutic anticoagulation are the independent predictors of it .
