急性心肌梗死患者GRACE评分与实验室指标的相关性

Correlation of GRACE score and laboratory index in patients with acute myocardial infarction

目的:研究急性心肌梗死(AMI)患者GRACE评分与实验室检查指标间的相关性。方法:回顾性分析2014-01-2016-09我院心内科收治的AMI患者186例,其中ST段抬高型心肌梗死(STEMI)125例(STEMI组),非ST段抬高型心肌梗死(NSTEMI)61例(NSTEMI组)。计算患者入院时GRACE评分,并将患者分为低危组、中危组、高危组。收集患者一般资料和实验室指标,分析GRACE评分与实验室指标间的相关性。结果:年龄、性别、饮酒史、红细胞压积、GRACE评分在STEMI组与NSTEMI组间差异有统计学意义(P<0.05),根据GRACE评分、红细胞压积、年龄绘制ROC曲线下面积分别为0.626[95%可信区间(CI):0.538~0.713,P<0.01]、0.633(95%CI:0.542~0.724,P<0.01)、0.665(95%CI:0.578~0.752,P<0.01),3者联合起来ROC曲线下面积为0.678(95%CI:0.592~0.763,P<0.01)。性别、吸烟、饮酒史、D-二聚体、纤维蛋白原降解产物、红细胞压积、红细胞分布宽度、红细胞平均体积、年龄在GRACE评分低、中、高危组间差异有统计学意义(P<0.05),相关性分析显示,D-二聚体、纤维蛋白降解产物、红细胞压积、红细胞分布宽度、红细胞平均体积、血小板压积、血小板平均体积、年龄与GRACE评分的相关性差异有统计学意义(P<0.05),多元线性回归显示年龄和纤维蛋白原降解产物与GRACE评分独立相关。结论:STEMI组与NSTEMI组患者年龄、性别、饮酒史、红细胞压积、GRACE评分间有差别,实验室检查指标与GRACE评分间有明显相关性。

Objective：To investigate the correlation between GRACE score and laboratory Index in patients with AMI.Method：There were 186 patients with AMI in this study,including 125 patients with ST-elevation myocardial infarction（STEMI）and 61 patients with non ST-elevation myocardial infarction（NSTEMI）.The baseline characteristics and laboratory index were cllected in all patients on admission.According to GRACE score,patients were divided into low,middle,high risk groups.Result：Age,sex,drinking,PRBC and GRACE score were different in STEMI and NSTEMI（P〈0.05）.The areas under the ROC curve in terms of GRACE score,PRBC,age and combined of three were 0.626（95%CI：0.538~0.713,P〈0.01）,0.633（95%CI：0.542~0.724,P〈0.01）,0.665（95%CI：0.578~0.752,P〈0.01）,0.678（95%CI：0.592~0.763,P〈0.01）,respectively.Sex,smoking,drinking,D-dimer,fibrinogen degradation products,PRBC,RDW,MCV,age were different among low,middle,high GRACE score groups（P〈0.05）.There were positive correlation between D-dimer,fibrinogen degradation products,PRBC,RDW,MCV,PCT,MPV,age and GRACE score（P〈0.05）.Multiple linear regression analysis showed that age,fibrinogen degradation products were independent influent factors of GRACE score.Conclusion：Age,sex,drinking,PRBC,GRACE score are different in STEMI and NSTEMI.There are great correlations between GRACE score and laboratory index.