急性主动脉综合征风险分层评分的应用价值  

Application value of acute aortic syndrome risk stratification score

作　　者：孟凡亮[1] 郭向杰[1] 骆海通 赵健 陈保敏 李会勇 李勇[1] 付凤霞 梁义 肖子亚 MENG Fanliang;GUO Xiangjie;LUO Haitong;ZHAO Jian;CHEN Baomin;LI Huiyong;LI Yong;FU Fengxia;LIANG Yi;XIAO Ziya(Department of Emergency,the Affiliated Hospital of Jining Medical University,Jining Shandong 272029,China)

机构地区：[1]济宁医学院附属医院急诊医学科,山东济宁272029 [2]济宁市第三人民医院急诊医学科,山东济宁272000 [3]济宁医学院附属金乡医院急诊医学科,山东济宁272200 [4]邹城市人民医院重症医学科,山东济宁273500

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期362-365,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：济宁市重点研发计划项目(2022YXNS045)。

摘　　要：目的评估急性主动脉综合征风险分层评分(AAS-RSS)在急性主动脉综合征(AAS)风险分层中的应用价值。方法按照前瞻性队列研究方法,收集2022年8月—2023年8月在济宁市4家三级医院急诊科就诊怀疑AAS患者,应用AAS-RSS对怀疑AAS患者进行风险分层,绘制受试者工作特征(ROC)曲线对AAS-RSS诊断效能进行评价。结果本研究共入组患者551例,根据AAS诊断标准分为AAS组265例和非AAS组286例。AAS-RSS分值高低与AAS的发生存在正相关,相关系数r=0.72,P<0.01。AAS-RSS、ADD-RS(主动脉夹层检测风险评分)预测发生AAS的ROC曲线下面积分别为0.917(0.894~0.940)、0.754(0.714~0.795)。AASRSS评分9分为区分高危AAS和低危AAS的界值。AAS-RSS识别高危AAS的灵敏度为92.10%,特异度为75.50%;ADD-RS识别高危AAS的灵敏度为50.90%,特异度为87.80%。结论AAS-RSS评分系统对AAS风险分层具有较高预测价值。Objective To explore the application value of acute aortic syndrome risk stratification score(AAS-RSS)in risk stratification of patients with acute aortic syndrome(AAS).Methods According to the prospective cohort study,Patients of hospitals in Jining between August 2022 and August 2023 were enrolled,the risk stratification was performed according to AAS-RSS with suspected AAS.The receiver operating characteristic(ROC)curve was drawn to evaluate the AAS-RSS.Results A total of 551 patients were enrolled in this study,the patients were divided into AAS and non-AAS groups according to the AAS diagnostic criteria.There were 265 patients in the AAS group,and there were 286 patients in the non-AAS group.There was a positive correlation between AAS-RSS and the occurrence of AAS,with a correlation coefficient of r=0.72,P<0.01.The areas under the AAS curve of the AAS-RSS and ADD-RS were 0.917(0.894~0.940)and 0.754(0.714~0.795),respectively.The AAS-RSS score of 9 was the cutoff value for distinguishing high-risk AAS from low-risk AAS.The sensitivity and specificity of AAS-RSS in identifying high-risk AAS were 92.10%and 75.50%,respectively;and those of the ADD-RS in identifying high-risk AAS were 50.90%and 87.80%,respectively.Conclusion The AAS-RSS has high predictive value for risk stratification of AAS.

关 键 词：急性主动脉综合征 急性主动脉夹层 风险分层 诊断 

分 类 号：R543.1[医药卫生—心血管疾病]