摘要
【目的】探讨全球急性冠状动脉事件注册(GRACE)评分预测急性心肌梗死(AMI)患者住院期间预后的价值。【方法】回顾性分析2018年3月至2019年3月本院收治的105例行急诊经皮冠脉介入术(PCI)治疗的AMI患者,根据患者住院期间临床转归情况将其分为预后良好组(n=21)及预后不良组(n=84)。计算所有患者GRACE评分,比较两组患者临床资料差异性。采用Pearson相关性分析GRACE评分与相关临床资料的关系;以受试者工作特征曲线(ROC)评估GRACE评分预测住院期间预后不良的效能;Logistic多元回归分析GRACE评分与AMI住院期间预后不良的相关性。【结果】预后不良组患者年龄、GRACE评分级血清心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽(BNP)、肌酐(Cr)水平显著高于预后良好组,LVEF显著低于预后良好组,差异有统计学意义(P<0.05)。Pearson相关性分析显示,GRACE与年龄及血清Cr、cTnI、BNP水平呈正相关性(P<0.05),与LVEF呈负相关性(P<0.05),而与CK-MB及胸痛时间无显著相关性(P>0.05)。ROC曲线分析显示,GRACE评分预测AMI住院期间预后不良的效能较高,其ROC曲线下面积(AUC)95%C/为0.79(0.69〜0.90),其最佳诊断界值为112分。最佳诊断界值GARCE评分〉112分与AMI患者住院期间预后密切相关,其优势比(OR)95%CI为1.17(0.85〜3.19),差异有统计学意义(P<0.05)。【结论】GRACE评分与AMI患者病情严重程度相关,GRACE评分>112分是AMI患者住院期间发生预后不良的危险因素。
【Objective】To investigate the value of global registry cf acute coronary events(GRACE)in predicting the prognosis of patients with acute niyocardial infarction(AMI)during hospitalization.【Methods】From March 2018 to March 2019,105 patients with AMI treated by emergency percutaneous coronary intervention(PCI)in our hospital were retrospectively analyzed.According to the clinical outcome of patients during hospitalization,they were divided into good prognosis group(n=21)and puor prognosis group(n=84).The grace scores of all patients were calculated,and the differences of clinical data between the two groups were compared.Pearson correlalion was used to analyze the relationship between grace score and related clini cal data;ROC was used to evaluate the efficacy of grace score in predicting poor prognosis during hospitalization;logistic multiple regression was used to analyze the correlation between grace score and poor prognosis during hospitalization of AMI.【Results】The ages GRACE score,serum cardiac troponin I(cTnI),creatine ki nase isoenzyme(CK-MB),N-terminal brain nalriurclic peplide(BNP)and creatinine(CR)levels in ihc poor prognosis group were significantly higher than those in the good prognosis group,while LVEF was significantly lower than that in the good prognosis group,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that GRACE was positively correlated with age and scrum Cr,cTnI,BNP levels(P<0.05),and negatively correlated with LVEF(P<0.05),but not with CK-MB and chest pain time(P>0.05).ROC curve analysis showed that grace score was more effective in predicting the poor prognosis of AMI during hospitalization.The area under ROC curve(AUC)95%CI was 0.79(0.69〜0.90),and the best diagnostic cut-off value was 112.The best cut-off value of GRACE score>112 was closely related to the prognosis of AMI patients during hospitalization.The odds ratio(OR)95%CI was 1.17(0.85〜3.19),and the difference was statistically significant(P<0.05).【Conclusion】GRACE score
作者
彭燕飞
宋初平
PENG Yan-fei;SONG Chu-ping(Liyang Branch of Jiangsu Provincial People's Hospital,Liyang Jiangsu 213300)
出处
《医学临床研究》
CAS
2021年第1期91-93,97,共4页
Journal of Clinical Research
关键词
心肌梗死
急性病
危险性评估
住院时间
预后
Myocardial Infarction
Acute Disease
Risk Assessment
Length of Stay
Prognosis
