TIMI危险评分对脑血管病合并急性心肌梗死患者预后的评估作用

TIMI risk score for prognosis of myocardial infarction complicated with cerebrovascular disease patient

目的研究TIMI危险评分对脑血管病合并急性ST段抬高型心肌梗死PCI术后患者预后的评估作用。方法回顾性分析河南省人民医院2018-09—2019-02经急诊收住院并诊断为脑血管病合并急性ST段抬高型心肌梗死(STEMI)患者222例,按照TIMI危险评分分为低危组(0~3分)71例(32.0%)、中危组(4~6分)87例(39.2%)和高危组(7~14分)64例(28.8%)。患者术前均给予负荷剂量阿司匹林联合氯吡格雷或替格瑞洛抗血小板以及抗凝药物,并进行经皮冠状动脉介入治疗(PCI),记录患者出院后1 a内主要不良心血管事件(MACE)发生率,分析不同组别间患者预后与TIMI危险评分的相关性。结果TIMI危险评分低危组、中危组、高危组1 a内MACE发生率分别为2.8%(2/71)、5.7%(5/87)、15.6%(10/64),高危组MACE发生率显著高于中危组与低危组,差异有统计学意义(P<0.05)。结论TIMI危险评分对脑血管病合并STEMI患者PCI预后评估具有一定临床意义。

Objective To evaluate the prognosis of patients with cerebrovascular disease complicated with acute ST-segment elevation myocardial infarction after PCI by TIMI risk score.Methods Retrospective analysis was performed on 222 patients admitted to Henan Provincial People’s Hospital from September 2018 to February 2019 who were diagnosed as cerebrovascular diseases complicated with acute ST-segment elevation myocardial infarction(STEMI),of which 161 men(72.5%) and 64 women(27.5%).According to the TIMI risk score,71 patients(32.0%) in the low-risk group(0-3 points),87 patients(39.2%) in the middl e-risk group(4-6 points) and 64 patients(28.8%) in the high-risk group(7-14 points) were divided into three groups.All patients were preoperatively given load-dose aspirin combined with clopidogrel or ticagrelor antiplatelet and anticoagulant drugs,and underwent percutaneous coronary intervention(PCI).Major adverse cardiovascular events(MACE) happened one year after discharge was recorded,and the relation between prognosis and TIMI risk score which were among three groups was analyzed.Results The MACE ratios of 2.8%(2/71),5.7%(5/87) and 15.6%(10/64) were in the low-risk,middle-risk and high-risk groups of TIMI risk scores for 1 year,severally.High risk group mace incidence was the highest among the three groups.All tests were P<0.05 considered statistically significant.Conclusion The TIMI risk score is of significance to the PCI prognostic assessment of STEMI patients with cerebrovascular diseases.