ISSN 2096-7446　CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2020, Vol. 1 ›› Issue (2): 108-112.

• 论著 • 上一篇    下一篇

两种评分系统对急性冠脉综合征患者不良事件预测价值比较

向林军 肖涛 王莎 张小红 郭美英 王晓琳 张月娟   

  1. 长沙市中南大学湘雅三医院急诊科

  • 收稿日期:2019-09-26 出版日期:2020-03-10 发布日期:2020-04-09

The comparison of two score system for the prediction of adverse events in patients with acute coronary syndrome

XIANG Linjun, XIAO Tao, WANG Sha, ZHANG Xiao hong, GUO Meiying, WANG Xiaolin, ZHANG Yuejuan   

  • Received:2019-09-26 Online:2020-03-10 Published:2020-04-09

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摘要：

目的：对比全球急性冠状动脉事件注册评分(global registry of acute coronaryevents, GRACE)与五因素(history&ECG&age&risks&troponin, HEART)评分对急性冠脉综合征(acute coronary syndrome,ACS)患者不良事件的预测价值。方法：选取2016年7月一2017年6月经急诊入院的ACS患者395例，在发病12h内入院行冠状动脉造影检查。收集患者一般资料、实验室相关检查。分别采用GRACE和HEART评分系统对患者进行风险评估，计算风险分层。随访患者发病后30 d,90 d内心血管不良事件发生情况，对比两种评分系统对急性冠脉综合征患者风险的预测价值。结果采用受试者工作曲线分析GRACE评分、HEART评分对急性冠脉综合征患者发病30 d内发生心血管不良事件的曲线下面积分别为0.738,0.736:90 d内发生心血管不良事件的曲线下面积〔AUC)分别为0.669,0.683。结论：两种评分系统对冠脉综合征高危患者发病30d内病情危险胜识别能力相同;急性冠脉综合征患者90d风险预测中，HEART评分系统在预测高危患者、识别低危患者的适用性优于GRACE评分。

Abstract:

Abstract ObjectiveTocompare global registry of acute coronary events(GRACE) score and five factors (history&ECG&age&risks&troponin,HEART) score for predicting adverse  events  in patients  with  acute  coronary syndrome(ACS). Methods：A total of 395  patients with ACS were collected from July 2016 to June 2017 for a retrospective  study.  All  were  examined  with  coronary  angiography  within 12 hours of disease onset.  We recorded patient's general information and laboratory tests. The  GEACE and  HEART score were both used for risk assess-ment and then risk stratification was calculated. Major adverse cardiovascular events (MACE) were followed up by telephone within 30 days and 90 days of the onset.Compare the two  score  system in the prediction of  risks in patients with  ACS. Results The receiver operating curve  (ROC)  analysis  showed that the  area under the  curve (AUC) of GRACE and HEART score for predicting the 30 days risk of MACE were 0.738 and 0.736 respectively. For predicting the 90 days risk of MACE,AUC of GRACE and HEART score were 0.669 and 0.683  respectively. Conclusion：The  GRACE  and  HEART  score  are  consistent  in  identifying  disease  risk  within 30 daysof  acutecoronary  syndrome onset. The HEART score is better than GRACE in predicting high risk and low risk  patients within 90 days of the onset.

Key words: Acute Coronary Syndrome; ,  Risk Assessment；Major Adverse Cardiac Events