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目的探讨房颤患者C H A D S2评分与C H A2D S2-V A S c评分对卒中风险预测的价值及对抗凝方案的指导。方法回顾性分析1 7 2例广东省人民医院神经内科住院的非瓣膜性房颤合并脑梗死患者,对其入院前情况进行C H A D S2评分与C H A2D S2-V A S c评分以进行脑卒中风险评估,并统计其出院带药情况。结果 1 7 2例患者C H A D S2评分≥2分占6 4.5 3%;C H A2D S2-V A S c评分≥1分<2分占9 8.2 6%,C H A2D S2-V A S c评分≥2分占9 0.7 0%。而治疗上:抗凝比例占4 0.1 1%,单抗血小板占3 8.9 5%,双抗血小板占1 0.4 6%,抗凝+抗血小板比例占8 9.5 2%,住院及住院无抗血小板或抗凝1 5例占8.7 2%。结论较高的C H A D S2及C H A2D S2-V A S c分数能够较好的判断非瓣膜性心房颤动患者的卒中危险分层,但C H A D S2及C H A2D S2-V A S c评分≥2分即给予抗凝治疗的方案可能存在抗凝过度。
Objective To investigate the value of C H A D S2 score and C H A2D S2-V A S c score in predicting stroke risk in patients with atrial fibrillation (AF) and to guide the anticoagulation strategy. Methods A retrospective analysis of 172 patients with non-valvular atrial fibrillation and cerebral infarction hospitalized in Department of Neurology, Guangdong Provincial People’s Hospital, CHAD S2 score and CH A2D S2-VAS c score before admission were used to assess stroke risk, And statistics of the discharge with medication situation. Results Seven hundred and seventy-two patients had a CHAD S2 score of ≥2, accounting for 4.53%, a CH A2D S2-VASc score of ≥1, 2, 9 8.26, and a CH A2D, S2-VAS, 0%. The treatment: anticoagulant ratio 4 0.1 1%, monoclonal antibody platelet 8.959%, double antiplatelet 1 0.4 6%, anticoagulant + antiplatelet accounted for 8 9.5 2%, hospitalization and hospitalization without antiplatelet or 15 cases of anticoagulation accounted for 8.7 2%. Conclusions The higher CHAD S2 and CH A2D S2-VASc scores can be used to better assess the risk stratification of stroke in patients with non-valvular atrial fibrillation. However, patients with CHAD S2 and CHA2D S2-VAS c score ≥2 points were given anticoagulant therapy There may be over-regimen of the program.