纤维蛋白原和GRACE评分对急性冠状动脉综合征患者冠状动脉介入手术预后的评估价值

Prognostic value of fibrinogen and GRACE score in patients with acute coronary syndrome after percutaneous coronary intervention

目的探讨纤维蛋白原和GRACE评分对急性冠状动脉综合征(ACS)患者冠状动脉介入(PCI)术后预后的评估价值。方法选取2010年1月至2013年12月首次诊断为ACS的患者370例,均进行PCI治疗,回顾性分析其临床资料。其中28例患者在术后随访3年内发生心血管不良事件(MACE),另随机选取术后随访3年内未发生MACE者48例。比较术后MACE者与非MACE者术前血液检查结果,包括肌钙蛋白T、超敏C反应蛋白、纤维蛋白原,分析其入院全球急性冠状动脉事件注册(GRACE)评分、Syntax评分、Gensini评分等指标的差异。结果术后随访3年,MACE发生率为7. 6%(28/370)。术后MACE者纤维蛋白原、GRACE评分高于非MACE者,差异均有统计学意义(P <0. 05)。术后MACE者hs-CRP、肌钙蛋白T、Syntax评分、Gensini评分与非MACE者比较,差异均未见统计学意义(P>0. 05)。结论纤维蛋白原、GRACE评分与ACS患者PCI术后心血管不良事件风险呈正相关,其检测值可预测远期心血管不良事件。

Objective To investigate the predictive value of fibrinogen and GRACE score in the prognosis of patients with acute coronary syndrome （ACS） after percutaneous coronary intervention （PCI）. Methods The clinical data of 370 patients who had been diagnosed as ACS for the first time from January 2010 to December 2013 were retrospectively analyzed. All of the patients were treated by PCI. Among them, 28 patients had adverse cardiovascular events （MACE） within 3 years after the operation, and 48 patients without MACE after following up for 3 years were selected at the same time. The results of preoperative blood tests of MACE patients and non MACE patients were compared, including troponin T, high sensitive C reactive protein, and fibrinogen, and the differences in the scores of GRACE score, Syntax score and Gensini score were analyzed. Results After 3 years of follow-up, the incidence of MACE was 7.6% （28/370）. The plasma fibrinogen and GRACE scores of MACE patients were higher than those of non MACE patients, the differences were significant （ P 〈 0.05 ）. There were no differences in hs-CRP, troponin T, Syntax score or Gensini score between MACE and non MACE patients （P 〉 0.05 ）. Conclusions Fibrinogen levels and GRACE scores have predictive value for the prognosis of ACS patients undergoing PCI.