SYNTAX评分和rSS评分对老年STEMI患者PCI治疗后不良预后的预测价值比较

Comparative analysis of the predictive value of SYNTAX score and rSS score for poor prognosis after PCI in elderly patients with STEMI

目的比较老年ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者在经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后,SYNTAX评分与rSS评分对患者术后不良预后的预测价值。方法选择沧县医院2018年4月至2020年4月收治的行PCI治疗的224例老年STEMI患者,分别于术前、术后对患者进行SYNTAX评分与rSS评分,并比较两种评分系统对患者术后不良预后的预测价值。结果根据是否发生术后不良预后情况分为两组,不良预后组52例与非不良预后组172例。两组患者的年龄、SYNTAX评分、rSS评分及总胆固醇浓度、原发性高血压(高血压)、脑梗死或短暂性脑缺血发作(TIA)发病率等比较,差异均有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,术后不良预后结局与患者年龄、SYNTAX评分、rSS评分、高血压、脑梗死或短暂性脑缺血发作、三支冠状动脉病变等指标相关(P<0.05);多因素Logistic回归分析结果显示,术后不良预后与患者年龄、rSS评分显著相关(P<0.05)。术后rSS评分对术后不良预后的预测特异度为75.2%,敏感度为83.2%,曲线下面积(AUC)为0.947。结论rSS评分对老年STEMI患者PCI治疗后不良预后的预测价值比SYNTAX评分更大。

Objectives To compare the predictive value of SYNTAX score and rSS score for poor prognosis in elderly patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 224 elderly STEMI patients treated with PC.I who were admitted to Cangxian Hospital from April2018 to April 2020 were selected.The SYNTAX score and rSS score were assessed on the patients before and after the operation.The predictive values of prognosis of the two scores were compared.Results The patients were divided into two groups according to whether the postoperative adverse prognosis occurred,52 cases in poor prognosis group and 172 cases in non-adverse prognosis group.Differences of the age,SYNTAX score,rSS score,serum concentration of total cholesterol,hypertension and incidence of cerebral infarction or transient ischemic attack(TIA)between the two groups were statistically significant(P<0.05).Univariate Logistic showed that postoperative poor prognosis related to the age,SYNTAX score,rSS score,hypertension,cerebral infarction or TIA,three coronary artery disease and other indicators(P<0.05);multivariate Logistic showed that postoperative poor prognosis significantly associated with the age and rSS score(P<0.05).The postoperative rSS score had a specificity of 75.2%,a sensitivity of 83.2%,and an area under the curve(AUC)of 0.947.Conclusions Compared with SYNTAX score,rSS score has a greater predictive value for poor prognosis after PCI in elderly patients with STEMI.