GRACE危险评分和NT-proBNP水平对急性冠脉综合征患者的近期预后价值  

Study of values of GRACE risk score and NT-pro BNP level for recent prognosis in patients with acute coronary syndromes

作　　者：马宏[1] 汤万春[1] 尤兆雄[1] 赵峰[1] 王利青[1] MA Hong;TANG Wan-chun;YOU Zhao-xiong;ZHAO Feng;WANG Li-qing(Department of Cardiology, fourth affiliated hospital, Inner Mongolia medical university, Baotou 014030, China)

机构地区：[1]内蒙古医科大学第四附属医院心内科,包头014030

出　　处：《中国循证心血管医学杂志》2016年第6期700-703,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 探讨全球急性冠状动脉事件注册（GRACE）评分及氨基末端脑钠肽前体（NTproBNP）水平对急性冠脉综合征（ACS）患者近期预后的预测价值。方法 入选2013年1月~12月在内蒙古医科大学第四附属医院心内科住院的160例ACS患者，收集患者入院时基线资料，进行GRACE风险评分；根据GRACE评分进行分组，≤108为低危组（26例），109～140为中危组（58例），＞140为高危组（76例）；并测定NT-proBNP水平，随访观察患者近期心血管不良事件（MACE）发生情况，并采用多元logistic回归分析方法判断GRACE评分、NT-proBNP与患者近期预后的相关性。结果 三组患者年龄、NT-proBNP及GRACE评分有统计学差异（P＜0.05）。三组患者在住院期间、随访30 d MACE发生率均有差别，差异有统计学意义（P＜0.01），高危组MACE事件发生率最高。直线相关回归分析显示GRACE评分与NT-proBNP呈正相关（r=0.580，P＜0.001，回归系数b=19.719，P＜0.001）。对住院期间、随访30 dMACE发生的危险因素进行多元logistic回归分析发现GRACE评分、NT-proBNP、年龄、吸烟及高脂血症是发生MACE事件的危险因素（P均＜0.05）。结论 GRACE评分及NT-proBNP水平对ACS患者近期预后有良好的预测价值，且二者呈直线相关。Objective To study the value of the global registered acute coronary events (GRACE) score andamino terminal brain natriuretic peptide precursor (NT-proBNP) levels in patients with acute coronary syndrome(ACS) for recent prognosis. Methods 160 patients with ACS were enrolled between January 2013 and December2013 from the fourth affiliated hospital of Inner Mongolia medical university. Baseline information were collected aswhen patients be hospitalized as well as GRACE score. Patients were divided into low risk group (GRACE score ≤108, 26 patients), medium risk group (GRACE score between 109 and 140, 58 patients), and high risk group (GRACEscore >140, 76 patients). NT-proBNP level was measured. Incidence of major adverse cardiac events (MACE) wasrecorded during follow-up. Multivariate logistic regression was used to analyze correlation between recent prognosisand GRACE score or NT-proBNP level. Results Among three groups, significant difference was shown with respectto age, NT-proBNP level and GRACE score (P<0.05). Incidence of MACE during hospitalization and 30 days’follow-up were different among three groups (P<0.01), the highest incidence rate occurred in high risk group.Results of linear regression showed that GRACE score was positively associated with NT-proBNP level (r=0.580、P<0.001,regression coefficient b=19.719、P<0.001). Results of multivariate logistic regression analysis showedthat GRACE score, NT-proBNP level, age, smoking and hyperlipidemia are risk factors of MACE (P<0.05).Conclusion GRACE score and NT-proBNP level was positively correlated, and they were valuable for recentprognosis in patients with ACS.

关 键 词：急性冠脉综合征 氨基末端脑钠肽前体 GRACE评分 心血管不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]