心率震荡联合出院GRACE评分预测早发STEMI患者PCI术后风险的价值  

Value of Heart Rate Turbulence Combined with Discharge GRACE Score in Predicting the Risk of PCI in Patients with Early-onset STEMI

作　　者：陈超[1] 朱成振 CHEN Chao;ZHU Chengzhen(Electrocardiogram Room,Yancheng First Hospital Affiliated of Nanjing University Medical College,Yancheng 224006,Jiangsu,China;Department of Cardiology,Yancheng First Hospital Affiliated of Nanjing University Medical College,Yancheng 224006,Jiangsu,China)

机构地区：[1]南京大学医学院附属盐城第一医院心电图室,江苏盐城224006 [2]南京大学医学院附属盐城第一医院心内科,江苏盐城224006

出　　处：《医学信息》2024年第20期67-71,共5页Journal of Medical Information

摘　　要：目的探讨窦性心率震荡(HRT)水平联合出院GRACE评分评估经皮冠状动脉介入治疗(PCI)早发ST段抬高型心肌梗死(STEMI)患者预后的价值。方法收集2020年1月-2021年12月于我院行PCI术的186例早发STEMI患者(男性≤55岁,女性≤65岁)临床资料及术后1年随访记录,根据是否发生主要不良心脑血管事件(MACCE)分为MACCE组(n=31)和非MACCE组(n=155),比较两组患者震荡初始(TO)、震荡斜率(TS)水平和出院GRACE评分,分析其评估患者预后的价值。结果MACCE组的TO和出院GRACE评分高于对照组、TS低于对照组(P<0.05);TO、TS和出院GRACE评分均是早发STEMI患者PCI术后1年内发生MACCE的独立危险因素(P<0.05)。TO、TS、出院GRACE评分及三者联合预测患者发生MACCE的受试者工作曲线(ROC)下面积分别为0.790、0.810、0.880、0.935,三者联合的曲线下面积及灵敏度和特异性均高于任意单一指标检测(P<0.05)。结论HRT水平和出院GRACE评分与行PCI术的早发STEMI患者预后密切相关,联合指标预测MACCE价值更高。Objective To investigate the value of heart rate turbulence(HRT)level combined with GRACE score in evaluating the prognosis of patients with early-onset ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods The clinical data and 1-year follow-up records of 186 patients with early-onset STEMI(male≤55 years old,female≤65 years old)who underwent PCI in our hospital from January 2020 to December 2021 were collected.According to the occurrence of major adverse cardiovascular and cerebrovascular events(MACCE),they were divided into MACCE group(n=31)and non-MACCE group(n=155).The initial turbulence(TO),turbulence slope(TS)level and GRACE score at discharge were compared between the two groups,and the value of them in evaluating the prognosis of patients was analyzed.Results The TO and discharge GRACE score of the MACCE group were higher than those of the control group,and the TS was lower than that of the control group(P<0.05).TO,TS and GRACE score at discharge were independent risk factors for MACCE within 1 year after PCI in patients with early-onset STEMI(P<0.05).The area under the receiver operating curve(ROC)of TO,TS,GRACE score at discharge and the combination of the three in predicting MACCE were 0.790,0.810,0.880 and 0.935,respectively.The area under the curve,sensitivity and specificity of the combination of the three were higher than those of any single index(P<0.05).Conclusion HRT level and discharge GRACE score are closely related to the prognosis of patients with early-onset STEMI undergoing PCI,and the combined index has a higher value in predicting MACCE.

关 键 词：窦性心率震荡 出院GRACE评分 经皮冠状动脉介入治疗 联合指标 

分 类 号：R541.4[医药卫生—心血管疾病]