不同预后评分系统对老年NSTE-ACS患者远期预后的评估价值

发布时间：2018-07-21 16:41

【摘要】：目的探索grace评分和syntax评分对老年非ST段抬高急性冠状动脉综合征(NSTE-ACS)患者远期预后的评估价值。方法老年NSTE-ACS患者400例,随访时间16~24个月,完成随访392例,其中药物治疗组205例,置入支架组162例,冠脉搭桥术组25例。各组有计算grace评分和syntax评分,根据评分情况分为低危组、中危组和高危组。Pearson法分析grace和syntax评分的相关性;Kaplan-Meier法进行生存分析;Cox比例风险回归模型进行各因素分析;通过ROC曲线下面积比较预测准确性。结果 grace评分与syntax评分之间呈正相关(r=0.562,P0.01)。grace评分得出的高危、中危、低危组患者心血管事件发生率依次降低(P0.01)。syntax得出的高危组和中危组患者心血管事件发生率明显高于低危组(P0.05),但高危与中危组之间差异无统计学意义(P0.05)。grace评分和syntax评分对老年NSTE-ACS患者远期预后均有重要的评估价值。对grace评分、syntax评分和两者联合评分行ROC曲线分析显示,两者均对老年NSTE-ACS患者远期心血管事件风险有良好的预测价值,但在95%CI有明显重叠。结论 grace和syntax评分存在相关性,均对老年NSTE-ACS患者远期预后有重要预测价值,两者联用可在一定程度上提升预测准确性。grace评分适合对老年NSTE-ACS患者远预后进行危险程度分层。
[Abstract]:Objective to explore the value of grace score and syntax score in the long-term prognosis of elderly patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods 400 elderly patients with NSTE-ACS were followed up for 16 ~ 24 months. 392 cases were followed up, including 205 cases in drug therapy group, 162 cases in stenting group and 25 cases in coronary artery bypass grafting group. Grace score and syntax score were calculated in each group. According to the score, they were divided into low risk group, middle risk group and high risk group. The correlation between grace and syntax score was analyzed by Kaplan-Meier method. The area under the ROC curve is compared with the prediction accuracy. Results there was a positive correlation between grace score and syntax score (r = 0.562 / P0.01). The incidence of cardiovascular events in low risk group was significantly higher than that in low risk group (P0.05), but there was no significant difference between high risk group and moderate risk group (P0.05) .grace score and syntax score. It is important to evaluate the long-term prognosis of elderly patients with NSTE-ACS. ROC curve analysis of grace score and combined score showed that both of them had a good predictive value for the long-term cardiovascular event risk in elderly patients with NSTE-ACS, but there was significant overlap at 95CI. Conclusion there is correlation between grace and syntax scores, both of them have important value in predicting the long-term prognosis of elderly patients with NSTE-ACS. Combined use of both can improve the accuracy of prediction to some extent. Grace score is suitable for stratification of the risk degree of distant prognosis in elderly patients with NSTE-ACS.
【作者单位】：张家港市第一人民医院心内科;
【分类号】：R541.4

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