MCG与ACC/AHA指南评估老年患者非心脏手术围手术期心血管事件

Cardiac Events Estimated by MCG and ACC/AHA during the Perioperative Periods of Non-cardiac Surgery for Elderly Patients

目的探讨心磁图(MCG)评估老年非心脏手术心血管事件的价值。方法比较MCG与ACC/AHA指南两种方法对196例老年非心脏手术中评估心血管事件的价值。结果对于心脏事件的发生,MCG磁偶标准积分(DML)>1且磁偶角度变化(Ad)<-110或>20与ACC/AHA指南中高危级评估相比,MCG预测法的敏感性高(100.00%比94.73%),特异性高(98.73%比91.13%),阳性预测值大(95.00%比72.00%),阴性预测值大(100.00%比98.63%),而假阳性率低(1.02%比7.14%),假阴性率低(0.00%比1.02%);两种方法与实际心血管事件发生情况不符合的病例数之间的差别有统计学意义(P<0.01)。结论MCG磁偶标准积分(DML)>1且磁偶角度变化(Ad)<-110或>20比ACC/AHA指南中高危级评估对老年非心脏手术心血管事件有更好的评估价值。

Objective To explore the value of MCG estimated cardiac events during the perioperative periods of noncardiac surgery for elderly patients. Methods To analyze the value of MCG （Magnetocrdiogram） and ACC/AHA guideline estimated cardiac events among 196 elderly patients during the perioperative periods of elderly non-cardiac surgery. Results Compared with the high risk estimation of ACC/ AHA guideline, MCG DML〉1 with Ad〈-110 or 〉20 nut only had the higher sensitiveness （100.00% vs 94.73% ） , specifieness （ 98.73% vs 91.13% ） ,positive predictive value （ 95.00% vs 72.00% ） and negative predictive value （ 100.00% vs 98.63% ） for cardiac events, but also had the lower false positive rate （ 1.02% vs 7.14% ） mad false negative rate （ 0.00% vs 1.02% ） . Compared with the actual cardiac events that occurred during the perioporative periods by the two methods,the difference had statistical significance（P〈0.01）.Conclusion MCG DML〉1 with Ad〈-110 or 〉20 is more advanced than the high risk estimation of ACC/AHA guideline in predicting cardiac events during the perioperafive periods of non-cardiac surgery for elderly patients.