摘要
目的探讨左室射血分数(left ventricular ejection fraction,LVEF)和全球急性冠状动脉事件注册(globalregistry of acute coronary events,GRACE)评分对急性冠状动脉综合征(acute coronary syndrome,ACS)患者住院期间发生主要不良心血管事件(major adverse cardiovascular events,MACE)的预测价值。方法 ACS患者325例,根据LVEF水平四分位数分成Q1～Q4组,根据GRACE积分将患者分为低危组、中危组与高危组。住院期间进行常规治疗,观察治疗后发生MACE的情况。结果低危组、中危组与高危组LVEF比较差异均有统计学意义(P<0.01);Q1～Q4组GRACE分值分别为123.51±26.94,113.41±24.18,109.75±31.69及111.68±29.93,Q1组与Q3,Q4组间比较差异有统计学意义(P<0.05);ACS患者LVEF与GRACE评分呈负相关(r=-0.248,P<0.01);住院期间治疗后发生MACE者18例(5.5%);ROC分析基线GRACE评分对ACS患者住院期间发生MACE的AUC为0.811(SE=0.064,95%CI:0.686～0.936,P<0.01);ROC分析基线LVEF对ACS患者住院期间发生MACE的AUC为0.806(SE=0.073,95%CI:0.663～0.950,P<0.01),LVEF和GRACE评分的AUC在预测ACS患者住院期间发生MACE的价值上差异无统计学意义(P>0.05)。结论 LVEF与GRACE对ACS患者住院期间危险分层和预测MACE有重要价值。
Objective To explore the prognostic value of left ventricular ejection fraction （LVEF） and global registry of acute coronary events （GRACE） scores to major adverse cardiovascular events （MACE） in the patients with acute coronary syndrome （ACS）. Methods A total of 325 ACS patients were divided into group Q1, Q2, Q3 and Q4. The GRACE risk score was used to divide the patients into low-risk group, middle-risk group and high risk group. All patients were observed MACE in hospital after regular treatment. Results There was a significant difference in LVEF among low-risk, middle-risk and high-risk groups （P〈0.01）. The GRACE risk scores were 123.51±26.94, 113.41± 24.18, 109. 75 ± 31. 69 and 111. 68± 29. 93 in group QI to Q4, which showed significant differences in group Q1 compared with group Q3 and Q4 （P〈0.05）. The LVEF was negatively correlated with GRACE risk score （r=-0. 248, P〈0.01）. MACE occurred in 18 patients （5.5%） during hospital stay. ROC analysis showed AUC of GRACE risk score was 0.811 （SE=0.064, 95%CI： 0.686 to 0.936, P〈0.01） andAUC of LVEF was 0.806 （SE=0.073, 95%CI： 0. 663 to 0. 950 P〈0.01） for predicting the risk of MACE. There was no significant difference in predicting value of AUC of LVEF and GRACE for ACS during hospital stay （P 〉 0. 05）. Conclusion LVEF and GRACE risk score have an important value to risk stratification and predicting MACE for patients with ACS during： hosoital stay.
出处
《中华实用诊断与治疗杂志》
2012年第12期1174-1176,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
新疆维吾尔自治区自然科学基金(2010211A44)
关键词
冠状动脉疾病
左心室射血分数
GRACE危险积分
心血管事件
Coronary artery disease
left ventricular ejection fraction
global registry of acute coronary eventsscore
major adverse cardiovascular events
