OPT-CAD评分和GRACE评分对急性ST段抬高型心肌梗死患者短期预后的预测价值分析  

Predictive Value of OPT-CAD Score and GRACE Score on Short-term Prognosis for Patients with Acute ST-segment Elevation Myocardial Infarction

作　　者：李蓉蓉 罗荣 盛建龙[1] LI Rongrong;LUO Rong;SHENG Jianlong(Department of Cardiology,the Second Hospita of Anhui Medical University,Hefei 230601,Anhui,China;Department of Cardiology,Jieshou City People's Hospital,Jieshou 236500,Anhui,China)

机构地区：[1]安徽医科大学第二附属医院心血管内科,安徽合肥230601 [2]界首市人民医院心血管内科,安徽界首236500

出　　处：《医学信息》2025年第8期75-79,共5页Journal of Medical Information

基　　金：2020年度安徽医科大学第二附属医院临床研究培育计划项目(编号:2020LCYB10);2021年度安徽医科大学校科研基金(编号:2021xkj162);2021年度安徽省高校科学研究项目(编号:KJ2021A0327)。

摘　　要：目的 探究OPT-CAD评分和GRACE评分对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后院内发生主要不良心血管事件(MACE)的评估价值。方法 本研究采用回顾性分析,对2019年1月-2021年5月在界首市人民医院住院接受PCI治疗的200例STEMI患者临床资料进行分析。收集STEMI患者基线病例资料,计算入院时OPT-CAD评分和GRACE评分,统计患者住院期间发生MACE(包括非计划二次PCI手术、再发急性心肌梗死、非致命性心力衰竭、心血管病因死亡)的情况;根据住院期间病情变化,将患者分为MACE组(34例)和无MACE组(166例)。比较OPT-CAD评分和GRACE评分对STEMI患者PCI术后院内发生MACE的预测效力。结果 单因素分析结果显示,入院时年龄、淋巴细胞计数、淋巴细胞百分比、NLR、肌酐、GRACE评分、OPT-CAD评分是影响患者院内MACE的相关因素(P<0.05);多因素分析显示,GRACE评分是STEMI患者PCI术后院内MACE发生的独立危险因素(P<0.05);ROC曲线分析显示,GRACE评分曲线下面积为0.821 (95%CI:0.733~0.910),OPT-CAD评分曲线下面积为0.687 (95%CI:0.587~0.788),GRACE评分对STEMI患者PCI术后短期MACE事件预测价值优于OPT-CAD评分(Z=3.294,P=0.001)。结论 GRACE评分对STEMI患者院内MACE预估效力优于OPT-CAD评分。Objective To explore the value of OPT-CAD score and GRACE score in evaluating major adverse cardiovascular events(MACE) for patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods A retrospective analysis was performed on 200 patients with STEMI who underwent PCI in Jieshou City People's Hospital from January 2019 to May 2021.The baseline data of STEMI patients were collected,and the OPT-CAD score and GRACE score at admission were calculated.The occurrence of MACE(including unplanned secondary PCI,recurrent acute myocardial infarction,non-fatal heart failure,cardiovascular death) during hospitalization was counted.According to the changes of the condition during hospitalization,the patients were divided into MACE group(34 patients) and non-MACE group(166 patients).The predictive efficiency of OPT-CAD score and GRACE score for in-hospital MACE in STEMI patients after PCI was compared.Results Univariate analysis showed that age at admission,lymphocyte count,lymphocyte percentage,NLR,creatinine,GRACE score and OPT-CAD score were related factors affecting in-hospital MACE(P<0.05).Multivariate analysis showed that GRACE score was an independent risk factor for in-hospital MACE in STEMI patients after PCI(P<0.05).ROC curve analysis showed that the area under the GRACE score curve was 0.821(95%CI:0.733-0.910),and the area under the OPT-CAD score curve was 0.687(95% CI:0.587-0.788),while the GRACE score was superior to the OPT-CAD score in predicting short-term MACE events in STEMI patients after PCI(Z=3.294,P=0.001).Conclusion GRACE score is superior to OPT-CAD score in predicting in-hospital MACE in STEMI patients.

关 键 词：急性ST段抬高型心肌梗死 OPT-CAD评分 GRACE评分 短期预后 

分 类 号：R542.22[医药卫生—心血管疾病]