冠心病SYNTAX评分与超声指导的脑梗死分型的相关性研究

Correlation Between SYNTAX Score of Coronary Heart Disease and Ultrasound-guided Cerebral Infarction Typing in Patients With Coronary Artery Diseases

目的:探索冠心病SYNTAX评分与超声指导的脑梗死分型的关系。方法:选取2018年10月至2019年9月于成都医学院第一附属医院在神经内科就诊并经过冠状动脉造影确诊的532例冠心病的患者为研究对象。根据CT或MRI影像结果,将患者分为新发脑梗死组(n=338)和非脑梗死组(n=194)。将冠状动脉SYNTAX评分按国际通用标准分为低危评分(≤22分)、中危评分(23~32分)和高危评分(≥33分)。脑梗死按超声指导的TOAST分型分为1、2、3、4、5型。分析SYNTAX评分与各型脑梗死的关系。结果:新发脑梗死组与非脑梗死组相比,SYNTAX评分较高[(21.14±14.40)分vs.(4.03±0.45)分,P<0.001],且中危评分(15.3%vs.3.1%)和高危评分(27.2%vs.1.6%)患者比例也较高(P均<0.001)。Logistic回归分析发现,SYNTAX评分(OR=1.159,95%CI:1.123~1.196,P<0.001)与脑梗死独立相关。338例新发脑梗死患者中,SYNTAX低危评分患者191例,发生3型脑梗死(89.5%)比例较高,而高危评分患者92例,发生1型脑梗死(66.3%)的比例较高;不同SYNTAX评分分层的各型脑梗死患者占比差异有统计学意义(P<0.001)。结论:在冠心病患者中,SYNTAX评分与脑梗死独立相关。不同SYNTAX评分分层与脑梗死TOAST分型有对应关系。

Objectives:To explore the relationship between SYNTAX Score of coronary heart disease and ultrasound-guided cerebral infarction classification in patients with coronary artery disease.Methods:532 patients diagnosed with coronary heart disease in the First Affiliated Hospital of Chengdu Medical College from October 2018 to September 2019 were selected as the research objects.According to the results of CT or MRI images,the patients were divided into cerebral infarction group(n=338)and non-cerebral infarction group(n=194).Patients were divided into 3 groups according to the SYNTAX score:low-risk(≤22 points),intermediate-risk(23-32 points)and high-risk(≥33 points)based on international standards.Cerebral infarction is divided into type 1,2,3,4,and 5 according to the TOAST classification guided by ultrasound.The relationship between SYNTAX score and various types of cerebral infarction was explored in tis patient cohort.Results:The SYNTAX score was significantly higher in the cerebral infarction group than in the non-cerebral infarction group([21.14±14.40]points vs.[4.03±0.45]points,P<0.001),and the prevalence of intermediate risk score(15.3%vs.3.1%)and the high risk score(27.2%vs.1.6%)was also significantly higher in the cerebral infarction group than in the noncerebral infarction group(P<0.001).Logistic regression analysis found that SYNTAX score(OR=1.159,95%CI:1.123-1.196,P<0.001)was independently related to cerebral infarction.Among the 338 patients with cerebral infarction,191 patients in the low SYNTAX score group had a higher proportion of type 3 cerebral infarction(89.5%),while 92 patients with high SYNTAX score had a higher proportion of type 1 cerebral infarction(66.3%).There was a statistically significant difference in the proportion of patients with various types of cerebral infarction in different SYNTAX score groups(P<0.001).Conclusions:The SYNTAX score is an independent risk factor for cerebral infarction.The risk stratification of SYNTAX score corresponds to the TOAST classification of cerebral infarction in this patient cohort.