摘要
目的探讨血清肌酐(serum creatinine,Scr)水平和肌酐清除率(creatinine clearance rate,Ccr)对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者死亡风险的预测价值。方法选取2016年7月至2017年7月本院接诊的145例急性STEMI患者为研究对象。记录所有患者的临床资料、Scr水平及Ccr,根据预后情况将研究对象分为生存组(120例)和死亡组(25例),比较两组的一般资料,应用ROC曲线分析Scr水平和Ccr的最佳截断点并判断其对STEMI患者死亡的预测价值。结果 Scr水平> 114.90μmol/L时预测患者死亡的灵敏度为0.84,特异度为0.75,AUC为0.785(95%CI:0.705～0.866);Ccr水平<70.50 ml/min时预测患者死亡的灵敏度为0.76,特异度为0.73,AUC为0.799(95%CI:0.704～0.893)。Scr水平升高、Ccr降低是急性STEMI患者30天内死亡的危险因素(P <0.05)。在校正了年龄、脑卒中、Killip分级等因素后,Scr升高、Ccr降低仍是急性STEMI患者30天内死亡的独立预测因子(P <0.05)。结论急性STEMI患者入院时Scr> 114.90μmol/L和Ccr <70.50 ml/min,对其30天内死亡具有较好的预测价值;高Scr水平和低Ccr是急性STEMI患者死亡的独立预测因子。
Objective To explore the predictive value of serum creatinine(Scr)and creatinine clearance rate(Ccr)on the risk of death in patients with acute ST-segment elevation myocardial infarction(STEMI).Method 145 patients with acute STEMI admitted to our hospital from July 2016 to July 2017 were selected as research subjects.Their clinical data,levels of Scr and Ccr were recorded.All patients were divided into survival group(120 cases)and death group(25 cases)according to whether they died or not.The general data of the two groups were compared.The best cut-off point of Scr and Ccr was analyzed by ROC curve and thier predictive values on STEMI patients were judged.Result The sensitivity,specificity and AUC for predicting death were 0.84,0.75,0.785(95%CI:0.705~0.866)respectively when Scr>114.90μmol/L.The sensitivity,specificity and AUC for predicting death were 0.76,0.73 and 0.799(95%CI:0.704~0.893)respectively when Ccr<70.50 ml/min.Elevated Scr level and decreased Ccr were risk factors for death of acute STEMI patients within 30 days(P<0.05).After adjusting for age,stroke,Killip grading,elevated Scr and decreased Ccr were still independent predictors of death in STEMI patients within 30 days(P<0.05).Conclusion Scr>114.90μmol/L and Ccr<70.50 ml/min have good predictive value for death in patients with acute STEMI within 30 days,and high Scr level and low Ccr are independent predictors of death in patients with acute STEMI.
作者
孙建平
王文玲
SUN Jian-ping;WANG Wen-ling(Department of Cardiovascular Medicine,Wangjing Hospital of Chinese Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国医学前沿杂志（电子版）》
2018年第10期61-64,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
急性ST段抬高型心肌梗死
血清肌酐
肌酐清除率
Acute ST-segment elevation myocardial infarction
Serum creatinine
Creatinine clearance rate
