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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。
Objective To investigate the screening value of STAF score (for the targeting of atrial fibrillation) and LADS score (1eft atrial diameter, age, diagnosis of stroke or TIA, smoking) on patients with acute ischemic stroke complicated with atrial fibrillation (AF). Methods Patients enrolled in undergraduate and clinically diagnosed as acute ischemic stroke from December 2013 to December 2014 were enrolled in this study. Demographic information, first National Institutes of Health Stroke Scale score (NIHSS) after admission, and general And / or long-range electrocardiogram, echocardiography, head and neck vascular assessment and other test results. STAF and LADS were scored on all patients respectively. The receiver operating characteristic (ROC) curve was drawn to determine the best cut-off point of STAF and LADS score to diagnose AF, and their respective sensitivity and specificity were calculated. Results A total of 331 patients were enrolled, including 211 males and 120 females, ranging in age from 31 to 92 years with a mean age of (64 ± 3.5) years. The area under the ROC curve of STAF score was 0.940. The STAF score ≥5 was the best cutoff point. The sensitivity and specificity of STAF score were 91.89% and 87.16% respectively. The area under the ROC curve of diagnosed AF with LADS score was 0.844, and the sensitivity and specificity of LADS score was 71.62% and 87.16% with LADS score> = 4 as the best cutoff point. The area under the ROC curve was higher than the LADS score in STAF score (P <0.005). Conclusion The STAF score and LADS score have good predictive value in the patients with acute ischemic stroke complicated with AF, and the STAF score is more accurate than LADS score.