GRACE风险评分联合外周血红细胞分布宽度对急性心肌梗死近期死亡风险的预测价值

Value of GRACE risk score combined with the peripheral distribution of red blood cell width in prediction of short-term mortality risk in patients with acute myocardial infarction

目的探讨全球急性冠状动脉事件注册（GRACE）风险评分联合外周血红细胞分布宽度（RDw）对急性心肌梗死（AMI）近期死亡风险的预测价值。方法选择2013年1月～2014年1月在秦皇岛市第二医院急诊科就诊的AMI患者280例为研究对象，根据治疗结局将患者分为死亡组和生存组，应用标准GRACE对两组患者进行风险评分，全自动血细胞分析仪测定RDW，比较两组患者GRACE评分和RDW的水平差异；以受试者工作特征曲线（ROC）下面积（AUC）表示对个体预后的判断能力。结果死亡组GRACE评分及RDW水平均显著高于存活组患者，两组比较差异有统计学意义（P〈0．05）。GRACE评分及RDW对AMI患者发病30d内因心血管疾病（CVD）死亡者的AUC分别为0．825、0．621，两者比较差异有统计学意义（P〈0．05）；GRACE联合RDW的AUC为0．905，高于单独应用GRACE评分的AUC（P〈0．05）。结论RACE评分联合RDW可提高对AMI患者30dCVD的预测价值。

Objective To investigate the value of GRACE risk score combined with the peripheral distribution of red blood cell width （RDW） in prediction of short-term mortality risk in patients with acute myocardial infarction （AMI）. Methods 280 patients with AMI from January 2013 to January 2014 in Emergency Department of the Second Hospital of Qinhuangdao City were selected as study objects, they were divided into death group and survival group according to the treatment outcome. The standard GRACE score was conducted on patients of two groups, automatic blood cell ana- lyzer was used to determine RDW, differences of GRACE score and RDW of two groups were compared. Receiver op- erating characteristic curve （ROC） and area under receiver operating characteristic curve （A UC） were used to predict the individual prognosis. Results The GRACE score and RDW in the death group were significantly higher than those of the survival group, the differences of two groups were statistically significant （P 〈 0.05）. The A UC of GRACE scores and RDW of AMI patients died due to cardiovascular disease （CVD） within 30 days were 0.825, 0.621 respectively, there was statistical significance difference between GRACE scores and RDW （P 〈 0.05）. A UC of GRACE combined with RDW was 0.905, higher than that of the single application of GRACE score （P 〈 0.05）. Conclusion The RACE score combined with RDW can improve the predictive value in patients with AMI died of CVD within 30 days.