全球急性冠状动脉事件注册评分与非ST段抬高型急性冠脉综合征患者急诊危重度指数的相关性分析

Correlation between GRACE Score and ESI in Patients with Non ST-segment Elevation Acute Coronary Syndrome

目的分析全球急性冠状动脉事件注册(GRACE)评分与非ST段抬高型急性冠脉综合征(NSTE-ACS)患者急诊危重度指数(ESI)的相关性。方法选取2016年4月—2017年4月南通大学附属医院胸痛中心上报到卫生部中国胸痛中心网站上的411例NSTE-ACS患者,其中ESIⅠ级7例、Ⅱ级127例、Ⅲ级133例、Ⅳ89例、Ⅴ级55例。收集患者年龄、心率、收缩压、Killip分级、血肌酐及危险因素(包括ST段压低、肌钙蛋白及院前心搏骤停)以计算GRACE评分,GRACE评分及其条目与NSTE-ACS患者ESI的相关性分析采用Spearman秩相关分析。结果 Spearman秩相关分析结果显示,GRACE评分(r_s=-0.600)及年龄(r_s=-0.321)、Killip分级(r_s=-0.243)、血肌酐(r_s=-0.151)、ST段压低(r_s=-0.459)、肌钙蛋白升高(r_s=-0.459)、院前心搏骤停(r_s=-0.124)与NSTE-ACS患者ESI呈负相关(P<0.05);心率(r_s=-0.064)、收缩压(r_s=-0.057)与NSTE-ACS患者ESI无直线相关关系(P>0.05)。结论 GRACE评分与NSTE-ACS患者ESI呈负相关,其可能成为NSTE-ACS患者急诊预检分诊的辅助工具。

ObjectiveTo analyze the correlation between GRACE score and ESI in patients with non ST-segment elevation acute coronary syndrome. MethodsA total of 411 non ST-segment elevation acute coronary syndrome patients reported on China Chest Pain Center Website of Ministry of Health were selected in the Chest Pain Center of the Affiliated Hospital of Nantong University from April 2016 to April 2017,thereinto 7 cases were Ⅰ -grade ESI,127 cases were Ⅱ -grade ESI,133 cases were Ⅲ -grade ESI,89 cases were Ⅳ -grade ESI,55 cases were Ⅴ -grade ESI.Age,heart rate,SBP,Killip grade,Scr and risk factors（including ST-segment depression,troponin and pre-hospital cardiac arrest）were collected to calculate GRACE score,Spearman rank correlation analysis was used to analyze the correlations of GRACE score and its clauses with ESI in patients with non ST-segment elevation acute coronary syndrome. Results Spearman rank correlation analysis results showed that,GRACE score（rs=-0.600）,age（rs=-0.321）,Killip grade（rs=-0.243）,Scr（rs=-0.151）,ST-segment depression（rs=-0.459）,elevation of troponin（rs=-0.459）and pre-hospital cardiac arrest（rs=-0.124）was negatively correlated with ESI in patients with non ST-segment elevation acute coronary syndrome（P〈0.05）,while no linear correlation was found between heart rate（rs=-0.064）,SBP（rs=-0.057） and ESI（P〉0.05）. Conclusion GRACE score is negatively correlated with ESI in patients with non ST-segment elevation acute coronary syndrome,may be a auxiliary mean of emergency triage for non ST-segment elevation acute coronary syndrome.