颈动脉粥样硬化斑块对非瓣膜性心房颤动病人缺血性脑卒中事件的预测价值

doi:10.3969/j.issn.1003-9198.2024.03.006

摘要/Abstract

摘要： 目的探讨颈动脉粥样硬化斑块对老年非瓣膜性心房颤动(NVAF)病人缺血性脑卒中事件的预测价值。方法纳入303例NVAF病人,根据是否合并缺血性脑卒中分为房颤伴脑卒中组(n=134)和房颤不伴脑卒中组(n=169)。采用单因素及多因素回归分析探讨NVAF病人缺血性脑卒中的预测因素,并进一步评估其预测价值。结果房颤伴脑卒中组中75.4%的病人存在颈动脉粥样硬化斑块,而非脑卒中组伴有颈动脉粥样硬化斑块的病人比例为66.3%,差异有统计学意义(P<0.05)。Logistic回归分析结果表明,颈动脉粥样硬化斑块以及CHA₂DS₂-VASc评分是NVAF病人缺血性脑卒中事件的独立危险因素。ROC曲线分析结果表明,颈动脉粥样硬化斑块联合CHA₂DS₂-VASc评分预测缺血性脑卒中的价值优于CHA₂DS₂-VASc评分。结论在老年NVAF病人中,颈动脉粥样硬化斑块与缺血性脑卒中事件密切相关。颈动脉粥样硬化斑块联合CHA₂DS₂-VASc评分预测缺血性脑卒中事件的价值优于CHA₂DS₂-VASc评分。

关键词: 心房颤动, 颈动脉粥样硬化斑块, 缺血性脑卒中, 老年人

Abstract: Objective To explore the predictive value of carotid atherosclerosis plaque for ischemic stroke events in the elderly patients with nonvalvular atrial fibrillation(NVAF). Methods A total of 303 patients with NVAF were enrolled in the study,and were divided into the atrial fibrillation with stroke group (n=134) and the atrial fibrillation without stroke group (n=169) based on whether they suffered from ischemic stroke events. The predictive factors of ischemic stroke in the patients with NVAF were analyzed by single and multivariate regression analysis, and the predictive value was further evaluated by receiver operating characteristic (ROC)curve. Results Among the patients with atrial fibrillation and stroke, 75.4% presented with carotid atherosclerosis plaque, compared with 66.3% in the patients without stroke (P<0.05). Logistic regression analysis showed that carotid atherosclerosis plaque and CHA₂DS₂-VASc score were the independent risk factors for ischemic stroke in the patients with NVAF.ROC curve analysis showed that the predictive value of carotid atherosclerosis plaque combined with CHA₂DS₂-VASc score was better than that of CHA₂DS₂-VASc score alone. Conclusions In the elderly patients with NVAF, carotid atherosclerosis plaque is closely related to ischemic stroke events. The value of carotid atherosclerosis plaque combined with CHA2DS2-VASc score in predicting ischemic stroke events may be better than CHA₂DS₂-VASc score alone.

Key words: atrial fibrillation, carotid atherosclerosis plaque, ischemic stroke, aged

中图分类号:

张丽莉, 李静, 丁林锋, 孙静娴, 蔡静波. 颈动脉粥样硬化斑块对非瓣膜性心房颤动病人缺血性脑卒中事件的预测价值[J]. 实用老年医学, 2024, 38(3): 236-239.

ZHANG Lili, LI Jing, DING Linfeng, SUN Jingxian, CAI Jingbo. Predictive value of carotid atherosclerosis plaque for ischemic stroke events in patients with nonvalvular atrial fibrillation[J]. Practical Geriatrics, 2024, 38(3): 236-239.

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