心肌梗死溶栓疗法危险评分对急性心肌梗死患者预后的评估价值研究

The value of thrombolysis in myocardial infarction risk score in evaluating prognosis of patients with acute myocardial infarction

目的：探讨心肌梗死溶栓疗法（TIMI）危险评分在预测急性心肌梗死（AMI）患者远期预后中的临床价值。方法：选取我院心血管内科收治的500例AMI患者进行研究,根据患者入院时的TIMI危险评分分为A组（TIMI危险评分≤3分）、B组（TIMI危险评分4~6分）、C组（TIMI危险评分≥7分）,对患者进行电话随访、患者门诊随诊等方式,统计分析3组患者5年内再发心血管不良事件及心源性死亡发生率。结果：C组患者的心肌梗死再发率、顽固性心绞痛发生率、恶性心律失常发生率、心力衰竭发生率、心源性死亡发生率、靶血管血运重建率均显著高于A、B组患者（P〈0.05）;当TIMI危险评分为9.4分时,灵敏度为0.831,特异度为0.864,诊断指数为1.695,ROC曲线下面积（AUC）为0.892。结论：TIMI危险评分在预测AMI患者再发心血管不良事件及患者远期心源性死亡方面具有一定的临床价值。

Objective：To investigate the clinical value of the risk score in predicting the prognosis of acute myocardial infarction（AMI）patients with thrombolysis in myocardial infarction（TIMI）.Method：Five hundred cases of cardiovascular medicine AMI patients selected in our hospital were studied.According to the patient＇s admission TIMI score,the patients were divided into group A（TIMI risk score≤3points）,group B（TIMI risk score 4~6points）,group C（TIMI risk score≥7points）.,etc,Statistically analyzed the recurrent cardiovascular events and cardiac mortality of the patientswithin five years by telephone follow-up and outpatient follow-up..Result：Recurrent myocardial infarction rate,refractory angina rate,malignant arrhythmia rate and incidence of heart failure,cardiac mortality in group C patients were significantly higher than those in group A and group B（P〈0.05）;When TIMI risk score was 9.4points,the sensitivity was 0.831,specificity was 0.864,diagnostic index was 1.695,the area under the ROC curve（AUC）value was 0.892.Conclusion：TIMI risk score has a certain clinical value in patients with AMI,recurrent cardiovascular events and long-term cardiac death.