GRACE评分联合白细胞计数及hsCRP对冠状动脉病变程度的预测  

GRACE score combined with white blood cell count and hsCRP to predict the severity of coronary artery

作　　者：朱锐[1,2] 吴校林[1,2] 陶红[1,2] 赵玉勤[1,2] 李彬[1,2] 沈青山[1,2] 

机构地区：[1]湖北文理学院附属医院 [2]襄阳市中心医院心血管内科,湖北襄阳441000

出　　处：《海南医学》2013年第21期3139-3142,共4页Hainan Medical Journal

摘　　要：目的了解GRACE评分联合白细胞计数及高敏C-反应蛋白(hsCRP)对急性冠脉综合征(ACS)患者冠状动脉病变程度预测的价值。方法选取2009年7月至2011年7月住院的ACS患者共290例,分为不稳定型心绞痛(UA)组173例,急性非ST段抬高型心肌梗死(NSTEMI)组31例及急性ST段抬高型心肌梗死(STEMI)组86例,对其进行GRACE危险评分、行冠脉造影、检测血常规和hsCRP,并分析与冠脉病变程度的关系。结果 NSTEMI组和STEMI组患者的GRACE评分、白细胞计数、中性粒细胞比例、hsCRP的结果均高于UA组,差异有统计学意义(P<0.05)。低分患者以单支病变和轻中度狭窄为主,高分患者以三支病变和重度狭窄为主。当白细胞计数和hsCRP值超过正常范围时,三支病变和重度狭窄的患者比例明显增高。结论随着GRACE危险评分分值、白细胞计数和hsCRP值的增加,ACS患者三支病变和重度狭窄的发生率呈升高趋势,故对冠脉病变程度有一定的预测价值。Objective To understand the value of GRACE score combined with white blood cell count and high-sensitivity C-reactive protein （hsCRP） in patients with acute coronary syndrome （ACS） to predict the severity of coronary artery.Methods A total of 290 hospitalized patients with ACS were enrolled from July 2009 to July 2011.The patients were divided into unstable angina （UA） group （n=173）,acute non-ST-segment elevation myocardial infarction （NSTEMI） group （n=31） and acute ST-segment elevation myocardial infarction （STEMI） group （n=86）.GRACE risk score,coronary angiography,white blood cell count and hsCRP were implemented and measured.The relationship between them and the degree of coronary artery disease was analyzed.Results The results of GRACE score,white blood cell count,neutrophil percentage,hsCRP in NSTEMI group and STEMI group were significantly higher than that of UA group （P〈0.05）.Patients with low GRACE score mainly has single-vessel disease and mild to moderate stenosis and patients with high GRACE score mainly has three-vessel disease and severe stenosis.When the results of white blood cell count and hsCRP was above the normal range,the proportion of patients with three-vessel disease and severe stenosis was significantly higher.Conclusion With the results of GRACE score,white blood cell count,hsCRP increase,the incidences of three-vessel disease and severe stenosis in ACS patients raise.Therefore,GRACE score,white blood cell count and hsCRP have some predictive value to the degree of coronary artery disease.

关 键 词：急性冠脉综合征 GRACE危险评分 白细胞计数 高敏C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]