TIMI危险积分对冠心病严重程度评估价值的临床研究  

Clinical study on value of severity of patient with coronary artery disease evaluated with the thrombosis in myocardial infarction risk score

作　　者：郑晓英[1] 孟新科[1] 李文广[1] 杨径[1] 魏刚[1] 方锐[1] 

机构地区：[1]深圳市第二人民医院急诊科ICU,518035

出　　处：《中国危重病急救医学》2004年第4期239-241,共3页Chinese Critical Care Medicine

摘　　要：目的　探讨 TIMI危险积分对冠心病 (CAD)严重程度的评估和预后预测的价值。方法　对 12 6例 CAD患者分别进行 TIMI危险积分评估和冠状动脉 (冠脉 )造影 ,分析 TIMI危险积分与冠脉狭窄程度、病变范围、病变性质的相关关系 ;比较 4种类型冠心病如稳定型心绞痛 (SA)、不稳定型心绞痛 (U A)、非 ST段抬高性心肌梗死 (NSTEMI)和 ST段抬高型心肌梗死 (STEMI)患者的 TIMI危险积分、冠脉狭窄程度、病变范围及病变性质的差异。结果　 TIMI危险积分与冠脉狭窄程度、病变范围、病变性质积分均有良好的相关性(r值分别为 0 .6 0 7、0 .5 6 9和 0 .36 7) ,TIMI危险积分越高 ,冠脉病变越重。SA与 U A、NSTEMI和 STEMI之间 ,UA与 NSTEMI和 STEMI之间 TIMI危险积分、冠脉狭窄程度积分差异有统计学意义 (P均 <0 .0 5 ) ;SA的 TIMI危险积分和狭窄程度积分明显低于急性冠脉综合征 (ACS) ,UA的 TIMI危险积分和狭窄程度积分明显低于心肌梗死 (MI) ,NSTEMI与 STEMI之间差异无统计学意义 (P>0 .0 5 ) ;4种类型冠心病病变范围相互比较 ,差异均无统计学意义 (P均 >0 .0 5 ) ;SA与 U A、NSTEMI和 STEMI之间病变性质积分比较 ,差异有统计学意义 (P均 <0 .0 5 ) ,SA的病变性质积分低于 ACS,而 U A、NSTEMI和ObjectiveTo explore the value of severity evaluating and outcome predicting on coronary artery disease(CAD) patients scored with the thrombosis in myocardial infarction(TIMI) risk score. MethodsAll of 126 patients with CAD were enrolled in study. TIMI risk score and coronary artery angiographic in them were performed respectively. Correlativity between TIMI risk score and clinical type of CAD,narrow severity,pathological changes limits and character of coronary artery were analyzed. Difference of scores of TIMI,narrow severity,pathological changes limits and character of coronary artery were compared among stable angina (SA),unstable angina (UA),unSTsegment elevation myocardial infarction (NSTEMI) and STsegment elevation myocardial infarction (STEMI) respectively. ResultsTIMI risk score significantly correlated with clinical type of CAD score,narrow severity score,pathological changes limits and character scores of coronary artery respectively(r=0.607 for narrow severity score,0.569 for pathological changes limits score,0.367 for pathological changes character score,all P<0.05). TIMI risk score increased company with severity of coronary artery pathological changes advancing. Significantly differences were found when TIMI risk scores were compared between SA and UA,NSTEMI and STEMI respectively as well as narrow severity scores (all P<0.05). Same results were found between UA and NSTEMI, STEMI respectively(all P<0.05). There had no significantly difference among pathological changes limits scores of SA,UA, NSTEMI , STEMI (all P>0.05). Significantly difference was found when pathological changes character scores were compared between SA and UA,NSTEMI,STEMI respectively as well as narrow severity scores (P<0.05),but contrary results were found between UA and NSTEMI, STEMI respectively (P>0.05). ConclusionTIMI risk score not only could be used to predict the possibility of heart accident,but also could be used to evaluate clinical type of CAD,narrow severity, pathological changes limits and charac

关 键 词：TIMI危险积分 冠心病 严重程度 预后 

分 类 号：R541.4[医药卫生—心血管疾病] R449[医药卫生—内科学]