作者：孟华，苏馨雅，陆雯雯，王兴甜，梁沛枫

单位：

1.750004宁夏回族自治区银川市，宁夏医科大学公共卫生与管理学院　 2.750004宁夏回族自治区银川市，宁夏环境因素与慢性病控制重点实验室　 3.750002宁夏回族自治区银川市，宁夏回族自治区人民医院 宁夏医科大学附属自治区人民医院病案统计科 通信作者：梁沛枫，E-mail：doctor_pf@126.com

Units：

1.School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China 2.Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan 750004, China 3.Department of Medical Record Statistics, People's Hospital of Ningxia Hui Autonomous Region/People's Hospital of Autonomous Region Affiliated to Ningxia Medical University, Yinchuan 750002, China Corresponding author: LIANG Peifeng, E-mail: doctor_pf@126.com

关键词：

心房颤动; 非瓣膜性心房颤动; 脑卒中; CHA2DS2-VASc评分; Meta分析;

Keywords：

Atrial fibrillation; N on-valvular atrial fibrillation; Stroke; CHA2DS2-VASc score; Meta-analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.256

Funds：

宁夏回族自治区重点研发计划项目（2021BEG03099）；宁夏自然科学基金资助项目（2020AAC03354）

摘要：

目的 系统评价CHA2DS2-VASc评分与中国非瓣膜性心房颤动(NVAF)患者脑卒中发生风险的相关性。方法 计算机检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Cochrane Library、Embase发表的CHA2DS2-VASc评分与中国NVAF患者脑卒中发生风险相关性的队列研究或病例对照研究，检索时限从建库至2022-03-10。提取纳入文献的资料，采用纽卡斯尔-渥太华量表(NOS)进行文献质量评价，采用Rstudio进行数据分析。结果 共纳入50篇文献，包括15篇队列研究和35篇病例对照研究。队列研究共纳入105 081例NVAF患者，其中4 364例发生脑卒中，脑卒中发生率为4.10%；病例对照研究总样本量为17 282例，其中发生脑卒中的NVAF患者4 498例。Meta分析结果显示，在CHA2DS2-VASc评分为连续型资料的文献中，病例组CHA2DS2-VASc评分高于对照组〔加权均数差(WMD)=1.59，95%CI(1.34，1.83)，P<0.05〕。以研究类型进行亚组分析，队列研究和病例对照研究的Meta分析结果均显示，病例组CHA2DS2-VASc评分高于对照组〔WMD=1.42，95%CI(1.07，1.76)，P<0.05；WMD=1.65，95%CI(1.33，1.97)，P<0.05〕。在CHA2DS2-VASc评分为分类资料的文献中，病例组CHA2DS2-VASc评分≥2分者占比高于对照组〔OR=3.03，95%CI(1.40，6.57)，P<0.05〕。结论 CHA2DS2-VASc评分与中国NVAF患者脑卒中的发生相关，但还需完善CHA2DS2-VASc评分的精确度，以提高其实用性。

Abstract：

【Abstract】　Objective To systematically evaluate the correlation between CHA 2DS2-VASc score and stroke risk in Chinese patients with non-valvular atrial fibrillation (NVAF) . Methods Databases including CNKI, VIP, Wanfang Data, CBM, PubMed, Cochrane Library and Embase from inception to March 10, 2022 were retrieved to search for cohort studies and case control studies on the correlation between CHA 2 DS 2-VASc score and stroke risk in Chinese patients with NVAF. The data of the included literature were extracted, the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included literature, and Rstudio was used for data analysis. Results A total of 50 articles were included, including 15 cohort studies and 35 case control studies. A total of 105 081 NVAF patients were included in cohort studies, of which 4 364 had stroke, with an incidence rate of 4.10%. The total sample size of case-control studies was 17 282, of which 4 498 NVAF patients had stroke. The results of meta-analysis showed that, in the literature with CHA2DS2-VASc score as continuous data, the CHA2DS2-VASc score in the case group was higher than that in the control group [weighted mean difference (WMD) =1.59, 95%CI (1.34, 1.83) , P < 0.05] . Subgroup analysis was conducted according to the study type, the results of meta-analysis of the cohort studies and case-control studies both showed that, the CHA 2DS2-VASc score in the case group was higher than that in the control group [ WMD=1.42, 95%CI (1.07, 1.76) , P < 0.05; WMD=1.65, 95% CI (1.33, 1.97) , P < 0.05] . In the literature with CHA2DS2-VASc score as categorical variable data, the proportion of CHA 2DS2-VASc score ≥ 2 in the case group was higher than that in the control group [ OR=3.03, 95%CI (1.40, 6.57) , P < 0.05] . Conclusion The CHA 2DS2-VASc score is associated with the occurrence of stroke in Chinese patients with NVAF, but the accuracy of the CHA 2DS2-VASc score needs to be improved to improve its practicability.

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