GRACE评分对急性心肌梗死患者的近期预后预测价值  

Prognostic value of GRACE score in patients with acute myocardial infarction

作　　者：朱明辉[1] 钱雪松[1] 盛宇峰[1] 

机构地区：[1]张家港市第一人民医院心内科,江苏215600

出　　处：《交通医学》2017年第6期520-523,共4页Medical Journal of Communications

摘　　要：目的:探究GRACE评分对急性心肌梗死(acute myocardial infarction,AMI)患者的近期预后的预测价值。方法:回顾性分析2012年3月—2016年9月收治的82例AMI患者的临床资料,按照GRACE评分将患者分为低危组(≤88分,7例)、中危组(89~118分,29例)和高危组(≥119分,46例),对患者进行跟踪记录,记录1年内患者的主要心脑血管不良事件(major adverse cardiac and cerebral vascular events,MACCE),包括全因死亡、心肌梗死、缺血性卒中、靶血管血运重建(target vessel revascularization,TVR),记录患者的出血情况,比较三组患者的冠动脉病变支数和冠动脉病变Geninis评分,并利用相关性分析检测GRACE评分与二者的关系,进而评价GARCE评分对急性心肌梗死患者的近期预后预测价值。结果:对三组患者MACCE与出血时间进行对比,MACCE中心肌梗死(0%,3.4%,8.7%)、全因死亡(0%,6.9%,10.7%)和出血事件(0%,10.3%,13.0%)发生的概率根据患者低危、中危、高危逐渐上升;对三组患者冠动脉支数和Geninis评分对比,单支血管病变的概率随着缓和低危(57.1%)、中危(24.1%)、高危(8.7%)逐渐增加,双支血管病变、三支血管病变和Geninis评分对着患者低危[28.6%,14.3%,(49.98±19.23)分]、中危[31.0%,44.8%,(65.99±39.04)分]、高危[43.5%,47.8%,(88.09±36.95)分]逐渐增大;对GRACE危险评分与患者病变血管支数和Geninis评分的相关性进行研究,GRACE评分与患者病变血管支数(r=0.312)和Geninis评分(r=0.395)呈正相关的关系,以上差异均具有统计学意义(P<0.05)。结论:GRACE危险评分对AMI患者近期预后具有预测价值,其患者病变血管支数和Geninis评分成正相关,GRACE评分越好,患者的病变血管支数和Geninis评分越好,建议在临床上应用其对患者的预后进行预测。Objective:To investigate the predictive value of GRACE score in the prognosis of patients with acute myocardial infarction(acute myocardial infarction,AMI).Methods:The clinical data of 82 AMI patients admitted to our hospital from March 2012 to September 2016 were retrospectively analyzed.According to the GRACE score,patients were divided into the low-risk group(≤88 points and 7 cases),the middle-risk group(89~118 points,29 cases) and the high risk group(≥119 points,46 cases).The patients were followed up and recorded the major adverse cardiac and cerebral vascular events(MACCE) were recorded.The patients' bleeding was recorded because of death,myocardial infarction,ischemic stroke and target vessel revascularization(TVR).The coronary artery lesion count and coronary artery lesion Geninis score of the three groups were compared and the correlated Sex analysis was used to detect the relationship between the GRACE score and the two,and then to evaluate the GARCE score in patients with acute myocardial infarction in the near future prognostic value.Results:MACCE myocardial infarction(0%,3.4%,8.7 %),The probability of all-cause death(0%,6.9%,10.7%) and bleeding events(0%,10.3%,13.0%) increased gradually according to the low,medium and high risk; Arterial count and coronary artery lesions Geninis score comparison,the probability of single vessel disease with moderate and low risk(57%),moderate risk(24.1%),high risk(8.7%) increased gradually,double vessel disease,Lesions and Geninis score were significantly lower in patients with low risk(28.6%,14.3%,49.98 ±19.23),moderate risk(31.0%,44.8%,65.99 ±39.04),and high risk(43.5%,47.8% 88.09±36.95).The relationship between the GRACE risk score and the lesion vessel count and the Geninis score was also studied.The GRACE score was significantly correlated with the lesion vessel count(r=0.312) and Geninis score(r=0.395)(P<0.05).Conclusion:The GRACE risk score has predictive value for the short-term prognosis of AMI patients,and the number of pathological vessels and Genin

关 键 词：GRACE评分 急性心肌梗死 近期预后 

分 类 号：R542.22[医药卫生—心血管疾病]