CAJ | 학술논문

目的：研究CHA2DS2-VASc[congestive heart failure，hypertension，age≥75y（doubled），diabetes mellitus，stroke （doubled）-vascular disease，age 65～74 and sex category（female）]评分与合并心房颤动的初发心源性卒中预后之间的关系。方法收集346例初发心源性卒中患者的相关临床资料，起病时的美国卫生研究院卒中量表（ National Institutes of Health Stroke Scale，NIHSS）评分以及90 d时改良Rankin量表（ modified Rankin Scale ，mRS）评分和CHA2 DS2-VASc评分，并对其进行分析。结果年龄、性别（女性）、吸烟史、高血压病史、充血性心衰病史、既往抗凝治疗史、入院时NHISS评分和CHA2 DS2-VASc评分在不同预后组中差异有统计学意义（ P ＜0.05）。 CHA2DS2-VASc评分与NIHSS评分（ρ＝0.324， P ＜0.01），mRS评分（ρ＝0.228， P ＜0.01）呈正相关，多因素Logistic逐步回归分析显示年龄、吸烟、抗凝治疗、CHA2 DS2-VASc评分、NIHSS评分是预测初发心源性卒中预后的独立因素。结论 CHA2 DS2-VASc评分不仅能够用于心房颤动患者卒中风险分层，而且还能预测卒中合并房颤患者的预后。
목적：연구CHA2DS2-VASc[congestive heart failure，hypertension，age≥75y（doubled），diabetes mellitus，stroke （doubled）-vascular disease，age 65～74 and sex category（female）]평분여합병심방전동적초발심원성졸중예후지간적관계。방법수집346례초발심원성졸중환자적상관림상자료，기병시적미국위생연구원졸중량표（ National Institutes of Health Stroke Scale，NIHSS）평분이급90 d시개량Rankin량표（ modified Rankin Scale ，mRS）평분화CHA2 DS2-VASc평분，병대기진행분석。결과년령、성별（녀성）、흡연사、고혈압병사、충혈성심쇠병사、기왕항응치료사、입원시NHISS평분화CHA2 DS2-VASc평분재불동예후조중차이유통계학의의（ P ＜0.05）。 CHA2DS2-VASc평분여NIHSS평분（ρ＝0.324， P ＜0.01），mRS평분（ρ＝0.228， P ＜0.01）정정상관，다인소Logistic축보회귀분석현시년령、흡연、항응치료、CHA2 DS2-VASc평분、NIHSS평분시예측초발심원성졸중예후적독립인소。결론 CHA2 DS2-VASc평분불부능구용우심방전동환자졸중풍험분층，이차환능예측졸중합병방전환자적예후。
Objective To investigate prognostic value of the CHA 2 DS2-VASc score [ congestive heart failure , hypertension , age≥75y (doubled), diabetes mellitus, stroke (doubled)-vascular disease, age 65~74 and sex category (female)] in an initial car-dioembolic stroke with atrial fibrillation .Methods A total of 346 initial cardioembolic stroke patients with atrial fibrillation was en-rolled.The clinical feature, the National Institutes of Health Stroke Scale (NIHSS) score on admission, and clinical outcome [modi-fied Rankin Scale (mRS) score after 90 days] were obtained and evaluated retrospectively according to the CHA 2DS2-VASc score. Results The rate of female, smoking, hypertension, congestive heart failure, anticoagulation and the level of age, NIHSS score, and CHA2 DS2-VASc score were significantly different between two prognostic groups ( P <0.05 ) .A positive correlation was observed be-tween CHA2DS2-VASc score and NIHSS score on admission (ρ=0.324, P <0.01), CHA2DS2-VASc score and mRS score (ρ=0.228, P <0.01).Logistic regression analysis showed that age , smoking, anticoagulation, the CHA2DS2-VASc score, and the NIH-SS score on admission were related to clinical outcome independently .Conclusions The CHA2 DS2-VASc score may be useful for not only evaluation of stroke risk but also prediction of clinical outcomes after stroke .