血清尿酸联合Gensini积分预测急性ST段抬高型心肌梗死患者预后的价值

Value of serum uric acid combined with Gensini score in predicting prognosis of patients with acute ST segment elevation myocardial infarction

目的探讨血清尿酸联合Gensini积分对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后预后的预测价值。方法选取408例行PCI治疗的STEMI患者作为研究对象,将术后发生主要不良心血管事件(MACE)的64例患者纳入观察组,将未发生MACE的344例患者纳入对照组。比较2组患者的冠状动脉病变、血清尿酸水平、Gensini积分及其他生化指标。结果观察组平均年龄、有糖尿病病史者占比、空腹血糖水平、血清尿酸水平、Gensini评分均高于对照组,差异有统计学意义(P<0.05)。年龄、糖尿病病史、血清尿酸、Gensini评分均为PCI术后发生MACE的独立影响因素(P<0.05)。血清尿酸联合Gensini评分对MACE的预测敏感性、特异性高于血清尿酸、Gensini评分,差异有统计学意义(P<0.05)。结论血清尿酸、Gensini积分均与STEMI患者PCI术后预后密切相关,两者联用可有效预测MACE发生风险。

Objective To investigate the value of serum uric acid combined with Gensini score in predicting prognosis of patients with acute ST segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI). Methods A total of 408 STEMI patients treated with PCI were selected as study objects, among whom 64 cases with Major Adverse Cardiovascular Events(MACE) were included in observation group, and 344 cases without MACE were included in the control group. Coronary artery lesions, serum uric acid, Gensini score and other biochemical indexes were compared between the two groups. Results The average age, the proportion of patients with history of diabetes, fasting blood glucose, serum uric acid and Gensini scores in the observation group were significantly higher than those in the control group(P<0.05). Age, history of diabetes, serum uric acid and Gensini score were independent influencing factors of MACE after PCI(P<0.05). The sensitivity and specificity of serum uric acid and Gensini score in combination in predicting MACE were significantly higher than those of serum uric acid and Gensini score(P<0.05). Conclusion Serum uric acid and Gensini score are closely related to the prognosis of STEMI patients after PCI. The combination of the two indexes can effectively predict the risk of MACE.