改良Gensini评分对2型糖尿病合并急性心肌梗死患者预后的预测价值  

The value of modified Gensini score in predicting prognosis in patients with type 2 diabetes mellitus complicated with acute myocardial infarction

作　　者：王丽萍[1] 徐敏[1] 缪羽霞 杨珍妮 江姝 高金梅 WANG Liping;XU Min;MIAO Yuxia(Echocardiography Room,First People's Hospital of Changzhou,Changzhou 213000,CHINA)

机构地区：[1]常州市第一人民医院(苏州大学附属第三医院)心超室,江苏常州213000

出　　处：《江苏医药》2022年第11期1101-1105,共5页Jiangsu Medical Journal

基　　金：常州市“十四五”卫生健康高层次拔尖人才培养工程(KY20221362);常州市卫健委青年人才科技项目(QN202208)。

摘　　要：目的评价改良Gensini评分对2型糖尿病(T2DM)合并急性心肌梗死(AMI)患者预后的预测价值。方法回顾性分析282例行冠状动脉造影术的T2DM合并AMI患者的临床资料,根据术后12个月随访结果分为主要不良心血管事件(MACE)组(80例)和非MACE组(202例)。采用多因素logistic回归分析建立T2DM合并AMI患者发生MACE的预测模型,应用ROC曲线分析其对预后的预测价值。结果与非MACE组相比,MACE组左心室射血分数(LVEF)较低,ST段抬高型心肌梗死患者比例较低(P<0.05)。单因素分析显示,心率预测T2DM合并AMI患者发生MACE的效能最佳(AUC=0.656)。基于LVEF、左心室舒张末期内径、血糖和B型脑钠肽等参数构建的改良Gensini评分预测效能(AUC=0.874)优于心率(P<0.05)。结论基于左心室结构和功能的改良Gensini评分对T2DM合并AMI患者MACE的发生具有较好的预测价值。Objective To evaluate the value of modified Gensini score in predicting the prognosis of the patients with type 2 diabetes mellitus(T2DM)complicated with acute myocardial infarction(AMI).Methods The clinical data of 282 T2DM patients with AMI undergoing coronary angiography were analyzed retrospectively.According to the follow-up results of 12 months,they were divided into two groups of MACE[with major adverse cardiovascular events(MACE),80 cases]and non-MACE(without MACE,202 cases).Multivariate logistic regression analysis was used to establish a predictive model of MACE in T2DM patients with AMI,and ROC curve was used to analyze its predictive value.Results Compared to group non-MACE,group MACE had lower left ventricular ejection fraction(LVEF)and lower proportion of the patients with ST segment elevation myocardial infarction(P<0.05).Univariate analysis showed that the heart rate had the best efficacy in predicting MACE in T2DM patients with AMI(AUC=0.656).The predictive efficacy of modified Gensini score based on LVEF,left ventricular end diastolic diameter,blood glucose,B-type brain natriuretic peptide and other parameters(AUC=0.874)was better than that of heart rate alone(P<0.05).Conclusion The modified Gensini score based on left ventricular structure and function has a good predictive value for the occurrence of MACE in T2DM patients with AMI.

关 键 词：改良Gensini评分 2型糖尿病 急性心肌梗死 左心室射血分数 

分 类 号：R542[医药卫生—心血管疾病]