不同评分对不稳定型心绞痛患者冠状动脉病变严重程度的预测价值

Predictive value of different scores for the severity of coronary artery disease in patients with unstable angina

目的探究不同评分对不稳定型心绞痛(UA)患者冠状动脉病变严重程度的预测价值。方法回顾性分析2018年1月-12月于我院行冠脉造影的681例UA患者的临床资料,分别计算患者的全球急性冠状动脉事件注册(GRACE)、心肌梗死溶栓疗法(TIMI)、韩国急性心肌梗死注册(KAMIR)评分和量化冠状动脉病病变严重程度的Gensini评分,并依据Gensini评分将患者分为轻度狭窄组(575例)、中度狭窄组(44例)和重度狭窄组(62例),分析不同组别间3种评分与Gensini评分的相关性,使用受试者工作特征(ROC)曲线评价3种评分对UA患者冠状动脉病变严重程度的预测价值。结果不稳定型心绞痛患者3种评分与Gensini评分均呈正相关关系,UA患者轻度狭窄组的GRACE评分、TIMI评分、KAMIR评分明显低于中度和重度狭窄组,3种评分与Gensini评分之间均呈正相关,且均能预测UA患者发生中度及重度病变事件,差异均有统计学意义(P<0.05)。结论KAMIR评分的预测效能优于GRACE评分和TIMI评分,说明患者血糖也是评价不稳定型心绞痛患者病变严重程度的重要指标。

Objective To explore the predictive value of different scores for the severity of coronary artery disease in patients with unstable angina(UA).Methods Clinical data of 681 patients with UA who underwent coronary angiography in our hospital from January to December 2018 were analyzed retrospectively.Global Register of acute coronary events(GRACE),thrombolysis in myocardial infarction(TIMI),Korean acute myocardial infarction registry(KAMIR)score and quantifying the severity of coronary artery disease Gensini score of the patients with coronary artery disease were calculated.According to the Gensini score,the patients were divided into mild stenosis group(575 cases),moderate stenosis group(44 cases)and severe stenosis group(62 cases).The correlation between the three scores and Gensini scores among different groups was analyzed.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of the three scores for the severity of coronary artery disease in UA patients.Results The three scores of UA patients were positively correlated with the Gensini score.GRACE score,TIMI score and KAMIR score of the mild stenosis group of UA patients were signifi cantly lower than those of the moderate and severe stenosis group,the three scores were positively correlated with the Gensini score,and all of them could predict the occurrence of moderate and severe disease events in UA patients(P<0.05).Conclusion The predictive power of KAMIR score is better than the GRACE score and TIMI score,indicating that the blood glucose is also an important indicator for evaluating the severity of the lesions in patients with unstable angina.