目的比较CHADS2和CHA2DS2-VASc 2种评分方法对心房颤动(房颤)人群的缺血性脑卒中风险评估的差异。方法采用前瞻性队列研究方法,对143例新发非瓣膜性房颤患者,用CHADS2和CHA2DS2-VASc 2种评分方法进行卒中风险评估,比较2种评估方法得分以及卒中危险分层的差异。结果 CHADS2平均得分为(1.51±1.28)分,CHA2DS2-VASc平均得分为(2.36±1.97)分,后者明显高于前者(P<0.01);CHA2DS2-VASc评分低危组19例(13.3%),低于CHADS2评分低危组的46例(32.2%)(χ2=11.21,P<0.01);CHA2DS2-VASc评分中危组的32例(22.4%),低于CHADS2评分中危组42例(29.4%)(χ2=4.57,P<0.01);CHA2DS2-VASc评分高危组的92例(64.3%),高于CHADS2评分高危组55例(38.5%)(χ2=20.76,P<0.01);CHADS2评分法中,低度、中度、高度风险组,脑卒中发生例数分别为1、2、3例;CHA2DS2-VASc评分法中,低度、中度、高度风险组脑卒中发生例数分别为0、0、6例。结论与CHADS2评分法比较,CHA2DS2-VASc评估卒中风险中、低危组比例降低,高危组比例升高。 Objective To compare the differences of ischemic stroke risk assessment between CHADS2 and CHA2DS2-VASc in patients with atrial fibrillation (AF). Methods A prospective cohort study was conducted to assess the risk of stroke in 143 patients with newly diagnosed non-valvular atrial fibrillation using the two methods of CHADS2 and CHA2DS2-VASc, and to compare the differences between the two evaluation methods and the risk stratification. Results The mean score of CHADS2 was (1.51 ± 1.28) points and the average score of CHA2DS2-VASc was (2.36 ± 1.97) points, which was significantly higher than the former (P <0.01) (32.2%) in CHADS2 low risk group (χ2 = 11.21, P <0.01), 32 (22.4%) in CHA2DS2-VASc moderate risk group were lower than those in CHADS2 low risk group (42.2% (64.3%) in high-risk CHA2DS2-VASc group was higher than that in CHADS2 high risk group (55.5%) (χ2 = 20.76, P <0.01); CHADS2 In the scoring method, the number of stroke cases was 1, 2, and 3 cases in the low, medium and high risk groups, respectively. In the CHA2DS2-VASc score method, the number of stroke cases in the low, medium and high risk groups were respectively 0,0,6 cases. Conclusions Compared with the CHADS2 score method, the proportion of low risk group and high risk group of CHA2DS2-VASc in assessing stroke risk decreases.