摘要
目的探讨SYNTAX评分联合连续心率减速力(DRs)在急性冠脉综合征(ACS)患者中的临床应用价值。方法选择2017年1月至2018年12月在本院心血管内科住院期间确诊ACS患者140例,确诊后均行PCI术,其中以有SYNTAX联合连续心率减速力评估(ACS前评估)为实验组,无ACS前评估为对照组,SYNTAX评分和DRs相关性分析采用Pearson分析;SYNTAX评分和DRs对预后的预测即生存分析采用Kaplan-Meier法;研究其发病时的患者时间、支架植入成功率、术中慢血流或无复流的发生率、ST段回落率、主要不良心脏事件(MACE)的差异性,采用随机临床对照试验(RCT)研究方法,比较两种方式的适用性。结果 SYNTAX评分和DRs存在弱相关(r=0.333,P<0.05)。生存分析示:SYNTAX、DRs分别评分得出的低、中、高危组MACE发生率逐渐升高,差异有统计学意义(P<0.05);低、中危组和中、高危组两两分析发现,二者差异有统计学意义(P<0.05)。有ACS评分较无ACS评分患者发病到球扩时间明显缩短、术中慢血流或无复流的发生率下降、ST段回落率上升、MACE发生率下降,差异均有统计学意义(P<0.05)。结论 SYNTAX评分和DRs存在相关性,二者对ACS的远近期评估均有重要价值,对ACS患者进行低、中、高危分层是适宜的。
Objective To evaluate the clinical value of SYNTAX score combined with continuous heart rate deceleration(DRs)in acute coronary syndrome(ACS)patients.Methods From January 2017 to December 2018,140 patients with ACS were selected from Department of Cardiovascular Medicine,People’s Hospital,Gaoming District.ACS patients were diagnosed in our hospital and were treated with PCI.The experimental group was treated with SYNTAX combined with continuous heart rate deceleration assessment(ACS pre-evaluation).Patients without ACS were assessed as a control group.Pearson analysis was used to analyze the correlation between SYNTAX score and DRs,and Kaplan-Meier method was used to predict the prognosis of SYNTAX score and DRs.The time of onset,the success rate of stent implantation,the incidence of slow blood flow or no reflow during operation,the rate of ST segment fall and the difference of major adverse cardiac events(MACE)were compared between the experimental group and control group.Results There was a weak correlation between SYNTAX score and DRs(r=0.333,P<0.05).Survival analysis showed that the incidence of MACE showed an increase trend in the low,middle and high risk groups classified by SYNTAX and DRs(P<0.05).The difference between low and middle risk groups and the difference between the middle and high risk group were statistically significant(P<0.05).The patients with ACS scores were significantly shorter than those without ACS scores,the incidence of intraoperative slow blood flow or no reflow decreased,the ST segment fall rate increased,and the MACE incidence decreased(P<0.05).Conclusion There was a correlation between SYNTAX score and DRs.Both of them were of great value in the long-term evaluation of ACS.It was appropriate to carry out low,middle and high risk stratification in patients with ACS.
作者
刘玉娟
余新东
罗才福
LIU Yu-juan;YU Xin-dong;LUO Cai-fu(Functional Department,People??s Hospital,Gaoming District,Foshan,Guangdong 528500,China)
出处
《热带医学杂志》
CAS
2019年第8期1012-1015,共4页
Journal of Tropical Medicine
基金
佛山市医学科技攻关项目(2018AB000314)
