GRACE评分、TIMI危险评分及BNP对急诊胸痛患者心血管不良事件的预测价值

Predictive Value of GRACE score, TIMI risk score, and BNP on Adverse Cardiovascular Events in Emergency Patients with Chest Pain

[目的]分析全球急性冠状动脉事件注册（GRACE）评分、心肌梗死溶栓疗法（TIMI）危险评分及B型尿钠肽（BNP）对急诊胸痛患者心血管不良事件（MACE）的预测价值。[方法]比较本院治疗的不同GRACE评分、TIMI危险评分的急性胸痛患者MACE的发生率及不同预后患者BNP水平的差异，分析GRACE评分、TIMI危险评分和BNP对住院期间MACE的预测价值。[结果]不同GRACE评分和不同TIMI危险评分患者MACE发生率由高到低分别为高危组、中危组和低危组，且各组之间比较差异均有显著性（P〈0．05）；发生MACE或死亡的患者其BNP水平明显高于未发生MACE和存活的患者，且两者相比较差异具有显著性（P〈0．05）；GRACE评分、TIMI危险评分和BNP均可预测患者MACE发生的危险，且均具有较好的拟合度。[结论]GRACE评分、TIMI危险评分及BNP对急诊胸痛患者MACE有较好的预测价值，可作为临床检测指标。

[Objective]To analyze the predictive value of GRACE （global registry of acute coronary events） score, TIMI （thrombolysis in myocardial infarction） risk score, and BNP （B-type natriuretic peptide） on adverse cardiovascular events in emergency patients with chest pain. [Methods]Patients with acute chest pain who were treated in our hospital were observed. GRACE risk score, TIMI risk score, and BNP level were analyzed in patients with major adverse cardiovascular events （MACE）. GRACE, TIMI risk score, and BNP were predictors of cardiovascular events during hospitalization. [Results]The rate of MACE in patients of different GRACE scores and TIMI scores ranged from high to low and were sorted into a high risk group, medium risk group, and low risk group, with statistically significant differences amongst the groups （ P〈0.05）. The BNP of patients who experienced MACE or death were significantly higher than that of patients who did not experience MACE and surviving patients （ P 〈0.05）. GRACE score, TIMI risk score, and BNP can predict the risk of cardiovascular events to a fitting degree. [Conclusion]GRACE score, TIMI risk score, and BNP have good predictive values for adverse cardiovascular events in emergency patients with chest pain, and can be used as clinical indicators.