SYNTAXⅡ评分系统对接受经皮冠状动脉介入治疗急性冠状动脉综合征患者临床预后预测价值研究

Predictive ability of SYNTAX scoring systemⅡfor clinical prognosis of patients with acute coronary syndrome undergoing percutaneous coronary interventions

目的探讨SYNTAXⅡ评分系统(SS-Ⅱ)对接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者12个月临床预后的预测价值。方法选取北部战区总医院自2016年3月至2019年3月收治的接受PCI且可计算SS-Ⅱ评分的16667例ACS患者为研究对象。根据SS-Ⅱ评分中位数将患者分入3组,分别为SS-Ⅱ低分组(评分≤45.43分,n=5555)、SS-Ⅱ中分组(评分45.43~53.70分,n=5556)、SS-Ⅱ高分组(评分≥53.70分,n=5556)。比较3组患者术后12个月的终点事件发生率。结果SS-Ⅱ高分组缺血事件、缺血事件独立组成成分(心性死亡、心肌梗死、卒中)、全因死亡发生率高于SS-Ⅱ低分组和SS-Ⅱ中分组,差异有统计学意义(P<0.05)。SS-Ⅱ中分组和SS-Ⅱ高分组出血学会研究联合会(BARC)3,5出血事件发生率高于SS-Ⅱ低分组,差异有统计学意义(P<0.05)。3组BARC 2,3,5出血事件发生率比较,差异无统计学意义(P>0.05)。结论SS-Ⅱ评分是预测ACS患者PCI术后12个月临床预后的良好工具,SS-Ⅱ评分越高,患者预后越差。

Objective To investigate the predictive ability of SYNTAX scoring systemⅡ(SS-Ⅱ)for clinical prognosis of patients with acute coronary syndrome(ACS)undergoing percutaneous coronary interventions(PCI).Methods A total of 16667 ACS patients receiving PCI and calculable SS-Ⅱscore from March 2016 to March 2019 in General Hospital of Northern Theater Command were selected as the study subjects.According to the median SS-Ⅱscore,patients were divided into 3 groups:SS-Ⅱscore low group(score≤45.43,n=5555),SS-Ⅱscore medium group(score 45.43-53.70,n=5556),SS-Ⅱscore high group(score≥53.70,n=5556).The incidence of end point events 12 months after surgery was compared among 3 groups.Results The incidence of ischemic events,independent components of ischemic events(cardiac death,myocardial infarction,stroke)and all-cause death in SS-Ⅱscore high group were higher than those in SS-Ⅱscore low group and SS-Ⅱscore medium group,and the difference was statistically significant(P<0.05).The incidence of bleeding academic research consortium(BARC)3,5 bleeding events in SS-Ⅱscore medium group and SS-Ⅱscore high group was significantly higher than that in SS-Ⅱscore low group(P<0.05).There was no significant difference in the incidence of BARC 2,3,5 bleeding events among the 3 groups(P>0.05).Conclusion SS-Ⅱscore is a good tool to predict the clinical prognosis of ACS patients 12 months after PCI.The higher SS-Ⅱscore is,the worse the prognosis is.