非ST段抬高急性冠状动脉综合征患者血浆D-二聚体与GRACE评分的相关研究

Correlation between the D-dimer and GRACE risk score in patients with non-ST-segment elevation acute coronary syndrome

目的:探讨非ST段抬高急性冠状动脉综合征(NSTE-ACS)患者血浆D-二聚体水平与全球急性冠状动脉事件注册(GRACE)评分的关系。方法:入选151例在我院住院的NSTE-ACS患者,其中不稳定性心绞痛(UA)40例,非ST段抬高心肌梗死(NSTEMI)111例。入院后测定血浆D-二聚体浓度,计算GRACE评分并进行危险分层,分析NSTE-ACS患者血浆D-二聚体水平与GRACE评分及危险分层的关系。结果:NSTEMI组D-二聚体含量的平方根及GRACE评分均高于UA组(P<0.05和P<0.01)。将所有NSTE-ACS患者作GRACE危险分层,高危组D-二聚体含量的平方根明显高于中危组及低危组(均P<0.01),中危组与低危组D-二聚体含量的平方根差异无统计学意义(P>0.05)。将所有NSTE-ACS患者按D-二聚体含量<1.0μg/ml和≥1.0μg/ml分为低D-二聚体组和高D-二聚体组,高D-二聚体组GRACE评分明显高于低D-二聚体组(P<0.01)。NSTE-ACS患者D-二聚体的平方根与GRACE评分呈正相关(r=0.335,P<0.01)。结论:NSTE-ACS患者血浆D-二聚体水平与GRACE评分具有良好的相关性。D-二聚体水平对于NSTE-ACS患者的早期危险分层具有一定的价值。

Objective： To explore the relationship between plasma D-dimer level obtained on admission and global registry of acute coronary events （GRACE） risk scores in patients with non-ST-segment elevation acute cor- onary syndrome （NSTE-ACS）. Method： A total of 151 NSTE-ACS patients admitted in our hospital were chosen, including 40 patients with unstable angina （UA） and 111 patients with non-ST-segment elevation myocardial in- farction （NSTEMI）. On admission plasma D-dimer was measured in all patients and the GRACE risk score was used for risk stratification. Analyze the relationship between D-dimer level and GRACE risk score as well as risk stratification in patients with NSTE-ACS. Result：The square root of plasma D-dimer of NSTEMI group was high- er than UA group （P〈0.05）, as well as GRACE risk score （P〈0.01）. According to GRACE risk stratification, the square root of D-dimer of high-risk group was the highest among the three groups （P〈0.01）. The GRACE risk score in patients of high D-dimer levels was significantly increased compared with patients of low D-dimer lev- els （P〈0. 01）. The square root of D-direct in patients with NSTE-ACS had positive correlation with the GRACE risk score （r=0. 335, P〈 0.01）. Conclusion： Increased plasma D-dimer level was associated with increased GRACE risk score in NSTE-ACS patients. Measuring D-dimer level is valuable for early risk stratification in pa- tients with NSTE-ACS.