急性胸痛评分及血清B型脑钠肽对急诊胸痛患者的预测价值  

The predictive value of acute chest pain score and serum BNP for patients with acute chest pain

作　　者：李荣杰[1] 吕博文[1] 莫俊强[1] 赵德明[1] LI Rong-jie;LYU Bo-wen;MO Jun-qiang;ZHAO De-ming(Department of Emergency,Xinhui Area People′s Hospital in Jiangmen City,Guangdong Province,Jiangmen529100,China)

机构地区：[1]广东省江门市新会区人民医院急诊科,广东江门529100

出　　处：《中国当代医药》2018年第34期16-18,22,共4页China Modern Medicine

摘　　要：目的探讨急性胸痛评分及血清B型脑钠肽对急诊胸痛患者的预测价值。方法分析我院2014年1月～2018年2月收治的500例急诊胸痛患者的临床资料,观察不同状态患者的GRACE评分、TIMI评分和血清B型脑钠肽水平情况,预后心血管不良事件的Logistic回归分析情况,GRACE评分、TIMI评分和血清B型脑钠肽水平对患者预后心血管不良事件的预测情况。结果急诊入院患者的GRACE评分、TIMI评分和血清B型脑钠肽水平均高于急诊观察患者,随访30 d内死亡患者的GRACE评分、血清B型脑钠肽水平均高于存活患者,有其他心血管不良事件患者的GRACE评分、TIMI评分和血清B型脑钠肽水平均高于无其他心血管不良事件患者,GRACE评分是急诊入院、随访30 d内死亡、急诊PCI术的独立风险因素,TIMI评分是急诊入院、急诊PCI术的独立风险因素。GRACE评分可以预测急诊入院、随访30 d内死亡、急诊PCI术、其他心血管不良事件,TIMI评分、血清B型脑钠肽水平均可以预测随访30 d内死亡、急诊PCI术、其他心血管不良事件,差异均有统计学意义(P<0.05)。结论 GRACE评分可以准确地预测急诊胸痛患者急诊入院、随访30 d内死亡、急诊PCI术、其他心血管不良事件的风险,值得临床推广应用。Objective To explore the predictive value of acute chest pain score and serum brain natriuretic peptide(BNP)for patients with acute chest pain.Methods Clinical data of 500 patients with acute chest treated in our hospital from January 2014 to February 2018 were analyzed,the GRACE score,TIMI score,serum BNP level of different condition patients,and the Logistic regression analysis of cardiovascular adverse events in prognosis,and the prediction of GRACE score,TIMI score and serum BNP level for patients′cardiovascular adverse events in prognosis were obderved.Results The GRACE score,TIMI score and serum BNP level of emergency admission patients were higher than those of emergency observation patients,the GRACE score,serum BNP level of death patients within 30 days after follow up were higher than those of survival patients,the GRACE score,TIMI score and serum BNP level of other cardiovascular adverse events patients were higher than those of having no other cardiovascular adverse events patients,and GRACE score was independent risk factor of emergency admission,death within 30 days after follow up and emergency PCI operation,and TIMI score was independent risk factor of emergency admission,and emergency PCI operation.The emergency admission,death within 30 days after follow up,emergency PCI operation,and other cardiovascular adverse events were predicted by GRACE score.Death within 30 days after follow up,emergency PCI operation,other cardiovascular adverse events were predicted by TIMI score,serum BNP level,and the differences were statistical significance(P<0.05).Conclusion The GRACE score can accurately predict the risk of emergency admission,death within 30 days after follow up,emergency PCI operation and other cardiovascular adverse events for patients with acute chest pain,it is worthy of clinical promotion and application.

关 键 词：GRACE评分 TIMI评分 血清B型脑钠肽 急性胸痛 心血管不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]