首页|CHA2DS2-VASc评分联合LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值

CHA2DS2-VASc评分联合LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 探讨心房颤动血栓发生危险度(CHA2DS2-VASc)评分联合左心室射血分数(LVEF)预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值.方法 回顾性分析 2019 年 12 月至 2021 年 12月郑州市中心医院收治的 299 例慢性心力衰竭合并永久性心房颤动患者的资料,根据是否发生认知功能障碍分为认知功能障碍组和认知功能正常组.分析CHA2DS2-VASc评分联合LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的价值.结果 认知功能障碍组患者性别、受教育程度、吸烟史、糖尿病、脑卒中、NYHA分级构成比与认知功能正常组患者比较,差异均有统计学意义(P<0.05),认知功能障碍组患者年龄、CHA2DS2-VASc评分、N端脑钠肽前体(NTproBNP)均高于认知功能正常组患者(P<0.05),认知功能障碍组患者收缩压、LVEF均低于认知功能正常组患者(P<0.05);年龄、受教育程度、LVEF、NTproBNP、CHA2DS2-VASc评分均是影响慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的独立危险因素(P<0.05);慢性心力衰竭合并永久性心房颤动患者CHA2DS2-VASc评分与LVEF呈负相关(r=-0.417,P=0.000);CHA2DS2-VASc评分,LVEF预测慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的最佳截断值分别为 4 分和 43%,二者联合的敏感度、特异度和AUC分别为 82.43%,96.03%和 0.930.结论 LVEF和CHA2DS2-VASc评分均是影响慢性心力衰竭合并永久性心房颤动患者发生认知功能障碍的独立危险因素,二者均可作为预测患者发生认知功能障碍的参考指标,且联合预测的价值更高.
The value of CHA2DS2-VASc scores combined with LVEF in predicting cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation
Objective To explore the value of score for atrial fibrillation recurrence risk score(CHA2DS2-VASc)combined with left ventricular ejection fraction(LVEF)in predicting cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation.Methods A retrospective analysis was conducted on the data of 299 patients with chronic heart failure combined with permanent atrial fibrillation admitted to Zhengzhou Central Hospital from December 2019 to December 2021.The patients were divided into a cognitive impairment group and a normal cognitive function group based on the presence of cognitive impairment.The value of CHA2DS2-VASc scores combined with LVEF in predicting cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation was analyzed.Results The gender,education level,smoking history,diabetes,stroke and NYHA classification composition ratio of the cognitive impairment group were significantly different from those of the normal cognitive function group(P<0.05).The age,CHA2DS2-VASc scores,N-terminal pro-brain natriuretic peptide(NT-proBNP)of the cognitive impairment group were higher than those of the normal cognitive function group(P<0.05).Systolic pressure and LVEF of the cognitive impairment group were lower than those of the normal cognitive function group(P<0.05).Age,education level,LVEF,NT-proBNP,and CHA2DS2-VASc scores were independent risk factors for cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation(P<0.05).The CHA2DS2-VASc scores in patients with chronic heart failure combined with permanent atrial fibrillation were negatively correlated with LVEF(r=-0.417,P=0.000).The best cutoff points for predicting cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation using CHA2DS2-VASc scores and LVEF were 4 points and 43%,respectively.The sensitivity,specificity,and AUC of the combination of the two were 82.43%,96.03%,and 0.930,respectively.Conclusion LVEF and CHA2DS2-VASc scores are independent risk factors for cognitive impairment in patients with chronic heart failure and permanent atrial fibrillation.Both of them can serve as reference indicators for predicting cognitive impairment in patients,and the combination of the two has a higher value in prediction.

CHA2DS2-VASc scoresLeft ventricular ejection fractionPermanent atrial fibrillationChronic heart failureCognitive impairment

栗若泰、赵建华、张世云

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新乡医学院第一附属医院神经内科 河南省老年性痴呆神经修复国际联合实验室,河南卫辉 453100

CHA2DS2-VASc评分 左心室射血分数 永久性心房颤动 慢性心力衰竭 认知功能障碍

河南省科技发展计划(2018)河南省医学科技攻关计划(联合共建项目)

182300410389LHGJ20190436

2024

10.20116/j.issn2095-0616.2024.05.41

中国医药科学
海峡两岸医药卫生交流协会 二十一世纪联合创新（北京）医药科学研究院

中国医药科学

影响因子：1.083
ISSN：2095-0616
年,卷(期)：2024.14(5)
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