[1]袁振华 关景霞 卢祖能.STAF及LADS评分筛查急性缺血性脑卒中患者合并心房颤动的临床研究[J].卒中与神经疾病杂志,2016,23(01):21-25.[doi:10.3969/j.issn.1007-0478.2016.01.006]
 Yuan Zhenhua,Guan Jingxia,Lu Zuneng.STAF and LADS score for screening atrial fibrillation in patients with acute ischemic stroke:a clinical research[J].Stroke and Nervous Diseases,2016,23(01):21-25.[doi:10.3969/j.issn.1007-0478.2016.01.006]
点击复制

STAF及LADS评分筛查急性缺血性脑卒中患者合并心房颤动的临床研究()
分享到:

《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第23卷
期数:
2016年01期
页码:
21-25
栏目:
论著
出版日期:
2016-03-01

文章信息/Info

Title:
STAF and LADS score for screening atrial fibrillation in patients with acute ischemic stroke:a clinical research
作者:
袁振华 关景霞 卢祖能
作者单位:430060 武汉大学人民医院神经内科[袁振华 关景霞 卢祖能(通信作者)]
Author(s):
Yuan Zhenhua Guan Jingxia Lu Zuneng
Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430060
关键词:
STAF评分 LADS评分 急性缺血性脑卒中 心房颤动
Keywords:
STAF score LADS score Acute ischemic stroke Atrial fibrillation
分类号:
R749.1
DOI:
10.3969/j.issn.1007-0478.2016.01.006
文献标志码:
A
摘要:
目的 探讨STAF评分(score for the targeting of atrial fibrillation)及LADS评分(1eft atrial diameter, age, diagnosis of stroke or TIA, smoking)对急性缺血性脑卒中患者合并心房颤动(AF)的筛查价值。方法 纳入2013年12月~2014年12月就诊于本科且临床诊断为急性缺血性脑卒中的患者,记录人口学信息、入院后首次美国国立卫生研究院卒中量表评分(NIHSS),以及普通和/或长程心电图、心脏彩超、头颈部血管评估等检查结果。分别对所有患者进行STAF及LADS评分,绘制受试者工作特征(ROC)曲线,以确定STAF和LADS评分诊断AF的最佳截断点,计算出各自的灵敏度与特异度。结果 共纳入331例患者,其中男211例,女120例,年龄31~92岁,平均年龄(64±3.5)岁。STAF评分诊断AF的ROC曲线下面积为0.940,以STAF评分≥5分作为最佳截断点,STAF评分的灵敏度与特异度分别为91.89%、87.16%。LADS评分诊断AF的ROC曲线下面积为0.844,以LADS评分≥4分作为最佳截断点,LADS评分的灵敏度与特异度分别为71.62%、87.16%。ROC曲线下面积STAF评分大于LADS评分,二者间有明显差异(P<0.005)。结论 STAF评分及LADS评分对急性缺血性脑卒中患者是否合并AF具有较好的预测价值,且STAF较LADS评分准确性更高。
Abstract:
ObjectiveTo study the value of STAF(score for the targeting of atrial fibrillation)and LADS(1eft atrial diameter, age, diagnosis of stroke orTIA, smoking)for screening atrial fibrillation(AF)in patients with acute ischemic stroke in China.Methods 331 consecutive patients with acute ischemic stroke referred to our department between Dec, 2013 and Dec, 2014 were enrolled, and the demographic information, the first-time National Institute of Health Stroke Scale(NIHSS)score after permission and the results of the vascular assessment of head and neck were collected. Every patient was evaluated by STAF score and LADS score respectively. Then according to the results, the receiver operator characteristic(ROC)curve to ascertain the optimal cutoff to screen AF was drew. At last, the sensitivity and specificity of STAF score and LADS score was calculated respectively, and the comparison of diagnostic accuracy between them was made.Results A total of 331 patients were collected, there were 211 males and 120 females, the age ranged from 31 years to 92 years, averaged(64±3.5)years. The area under the ROC curve of STAF score to screen AF was 0.940. The sensitivity and specificity of the STAF score were 91.89%and 87.16% respectively when the optimal cutoff was 5. The area under the ROC curve of LADS score to screen AF was 0.844.Thesensitivity and specificity of the STAF score were 71.62% and 87.16% respectively when the optimal cutoff was 4. The area under the ROCcurve of STAF is larger than LADS and they had significant difference(P<0.005).Conclusion STAF score and LADS score are both suitable for Chinese population, they had a good screening value for atrial fibrillation in patients with acute ischemic stroke. Meanwhile, STAF score is better than LADS score in accuracy.

参考文献/References:

[1] Heldner MR,Zubler C,Mattle HP,et al.National institutes of health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke[J].Stroke,2013,44(4):1153-1157.
[2] Wolf PA,Abbott RD,Kannel WB.Atrial fibrillation as an Independent risk factor for stroke: the Framingham Study[J].Stroke,1991,22(8):983-988.
[3] Stewart S,Hart CL,Hole DJ,et al.Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study[J].Heart,2001,86(5):516-521.
[4] European Atrial Fibrillation Trial Study Group. Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke[J]. Lancet, 1993, 342(8882): 1255-1262.
[5] Ntaios G,Papavasileiou V,Diener HC,et al.Nonvitamin-K-antagonist oral anticoagulants in patients with atrial fibrillation and previous stroke or transient ischemic attack: a systematic review and meta-analysis of randomized controlled trials[J].Stroke,2012,43(12):3298-3304.
[6] Hart RG,Pearce LA,Aguilar MI.Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation[J].Ann Intern Med,2007,146(12):857-867.
[7] Suissa L,Bertora D,Lachaud S,et al.Score for the targeting of atrial fibrillation(STAF): a new approach to the detection of atrial fibrillation in the secondary prevention of ischemic stroke[J].Stroke,2009,40(8):2866-2868.
[8] Malik S,Hicks WJ,Schultz L,et al.Development of a scoring system for atrial fibrillation in acute stroke and transient ischemic attack patients: the LADS scoring system[J].J Neurol Sci,2011,301(1/2):27-30.
[9] Horstmann S,Rizos T,Güntner J,et al.Does the STAF score help detect paroxysmal atrial fibrillation in acute stroke patients[J]?European Journal of Neurology,2013,20(1):147-152.
[10] 刘小艳,黎泳欣,徐安定,等.STAF评分在缺血性卒中患者心房颤动筛查的应用[J].中国神经精神疾病杂志,2013,39(9):534-537.
[11] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华医学信息导报,2010,25(14):16-19.
[12] Adams HJ,Bendixen BH,Kappelle LJ,et al.Classification of subtype of acute ischemic stroke.Definitions for use in a multicenter clinical trial.TOAST.Trial of Org 10172 in Acute Stroke Treatment[J].Stroke,1993,24(1):35-41.
[13] O'donnell MJ,Xavier D,Liu L,et al.Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries(the INTERSTROKE study): a case-control study[J].Lancet,2010,376(9735):112-123.
[14] Adams HP, Woolson RF, Helgason C, et al. Low molecular weight heparinoid, ORG 10172(Danaparoid), and outcome after acute ischemic stroke-A randomized controlled trial[J]. JAMA, 1998, 279(16): 1265-1272.
[15] Kolominsky-Rabas PL,Weber M,Gefeller O,et al.Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study[J].Stroke,2001,32(12):2735-2740.
[16] Wang Y,Liao X,Zhao X,et al.Using recombinant tissue plasminogen activator to treat acute ischemic stroke in China: analysis of the results from the Chinese National Stroke Registry(CNSR)[J].Stroke,2011,42(6):1658-1664.
[17] Gladstone DJ,Spring M,Dorian P,et al.Atrial fibrillation in patients with cryptogenic stroke[J].N Engl J Med,2014,370(26):2467-2477.
[18] Miller DJ,Khan MA,Schultz LR,et al.Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic stroke[J].J Neurol Sci,2013,324(1/2):57-61.
[19] Sposato LA,Cipriano LE,Saposnik G,et al.Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis[J].The Lancet Neurology,2015,14(4):377-387.
[20] Kernan WN,Ovbiagele B,Black HR,et al.Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American heart association/American stroke association[J].Stroke,2014,45(7):2160-2236.

备注/Memo

备注/Memo:
基金项目:湖北省卫计委重点项目(WJ2015MA007); 武汉市科技局2015年应用基础研究计划项目(2015060101010047); 国家自然科学基金资助项目(项目批准号为81301010)
更新日期/Last Update: 1900-01-01