SNYTAX积分Ⅱ对急性冠脉综合征患者介入治疗后远期主要不良心血管事件的预测价值  

Value of the SNYTAX score Ⅱ in predicting long-term clinical outcomes in patients after percutaneous coronary intervention with acute coronary syndrome

作　　者：安丽丽[1] 黄文正[1] 张新梅[1] 王莉[1] 李亚光[1] AN Li-li;HUANG Wen-zheng;ZHANG Xin-mei;WANG Li;LI Ya-guang(Cardiovascular Department of Internal Medicine,Hebei Central Energy Fengfeng Group General Hospital,Han.dan,Hebei 056002,China)

机构地区：[1]冀中能源峰峰集团总医院邯郸院区心内科,河北邯郸056002

出　　处：《岭南心血管病杂志》2019年第1期9-13,52,共6页South China Journal of Cardiovascular Diseases

基　　金：邯郸市科技计划项目(项目编号:1723208014ZC)

摘　　要：目的评估SNYTAX积分Ⅱ(SYNTAX scoreⅡ,SS-Ⅱ)对急性冠状动脉(冠脉)综合征患者介入治疗后远期主要不良心血管事件(major adverse cardiovascular event,MACE)的预测价值。方法本研究连续纳入自2008年1月至2013年12月于冀中能源峰峰集团总医院行介入治疗的1191例急性冠脉综合征患者,对患者的临床资料行回顾性观察性研究。根据SS-Ⅱ的数值,分为低SS-Ⅱ组、中SS-Ⅱ组和高SS-Ⅱ组。我们对患者的基线资料、介入资料以及两年的随访结果进行比较。统计分析使用SPSS软件。结果临床基线特征显示,与低SS-Ⅱ组相比,高SS-Ⅱ组的患者年龄更大,血管病变更复杂,有更多的复杂并发症。两组患者造影特征和介入治疗特征比较显示,高SS-Ⅱ组有更多的患者合并复杂造影特征,以及更复杂的介入情况。高SS-Ⅱ组患者介入成功率更低,植入支架更多,介入治疗时间更长,住院时间更长,且残余SNYTAX积分更高。2年随访发现高SS-Ⅱ组病死率和MACE发生率明显高于其他组,差异有统计学意义。多因素Cox回归分析后发现,死亡的独立预测因子包括SS-Ⅱ;MACE的独立预测因子包括SS-Ⅱ,高脂血症,PCI治疗成功,主动脉球囊反搏植入,介入治疗时间。对于2年病死率,SS-Ⅱ的预测效果明显优于基线SYNTAX积分和残余SYNTAX积分。但对于2年MACE,SS-Ⅱ的预测效果并不优于基线SYNTAX积分和残余SNYTAX积分。结论与基线SYNTAX积分和残余SYNTAX积分相比,SS-Ⅱ是个更为优秀的风险评估工具,可以较为准确地预测急性冠脉综合征行介入治疗患者的2年死亡风险。:Objectives To evaluate the predictive value of SYNTAX scoreⅡ(SS-Ⅱ)for the long-term clinical outcomes in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods From January 2008 to December 2013,a total of 1 191 consecutive ACS patients admitted to Fengfeng Group General Hospital and underwent PCI were enrolled in this retrospective,observational study.Accordingly to the SS-Ⅱ,patients were divided in low SS-Ⅱgroup,mid SS-Ⅱgroup and high SS-Ⅱgroup.Basic clinical data,PCI data and outcomes of two-year follow-up of the 3 groups were compared.Statistical analysis were performed by SPSS software for Windows.Results Compared with patients in low SS-Ⅱgroup,patients in high SS-Ⅱgroup were older and more likely to have more complex complications.High SS-Ⅱgroup had a more complex angiographic and procedural situation.High SS-Ⅱgroup had longer procedural duration,more residual stenosis,longer in-hospital duaration.The 2-year cardiac death and major adverse cardiovascular event(MACE)rate were both significantly higher in high SS-Ⅱgroup than in mid and low SS-Ⅱgroups.In multivariate COX analysis,the independent predictors of cardiac death were SS-Ⅱ,as well as increasing SS-Ⅱwas also an independent predictor of MACE,along with intra-aortic balloon pumping(IABP),hypercholesterolemia,successful PCI,procedural duration.Receiver operator characteristic curves(ROC)for cardiac death and MACE at 2-year follow-up showed that SS-Ⅱwas superior to baseline SS and residual SS in predicting 2-year cardiac death,but wasn′t superior in predicting 2-year MACE.Conclusions In ACS patients after PCI,SS-Ⅱis a suitable predictor in risk stratifying and demonstrated superiority in predicting 2-year clinical outcome compared with the angiographic SYNTAX score and the residual SYNTAX score.

关 键 词：冠状动脉疾病 SNYTAX积分Ⅱ 急性冠脉综合征 介入治疗后 远期预后 

分 类 号：R541.4[医药卫生—心血管疾病]