急诊非ST-T抬高急性冠脉综合征早期危险分层的临床意义

The Qinical Significance of Early Stratification for Non - ST Elevation Acute Coronary Syndrome

目的:评价早期危险分层对于急诊的非ST-T抬高的急性冠脉综合征患者诊断及治疗的临床意义。方法:根据症状,心电图,肌钙蛋白进行危险分层,高危患者即刻行冠脉造影,并选择治疗方法,低危患者经入院药物治疗一段时间后行冠脉造影检查。通过冠脉造影结果对危险分层及治疗干预进行评价。结果:高危患者的血管病变支数及闭塞程度大于90％血管支数明显高于低危组。高危患者较低危患者有更多需进行血管重建治疗。结论:对非ST-T抬高急性冠脉综合征患者进行早期危险分层,高危患者立即行冠脉造影有助于发现危险病变,积极进行干预,但远期愈后需进一步评价。

Objective: To evaluate the clinical significance of earlier risk stratification on the treatment and diagnosis of non ST-Televation ACS . Methods: Patients were stratified by Symptom, ECG, troponin I, High risk patients were immediately receiving angiogram, Low risk patients were triaged to CCU and wards for later angiogram. Coronary vessels lesion, invasive therapy were compared. Results: Compare with low risk group, the number of injured coronary vessel and stenosis less than 90% was significantly higher in high risk group. More high risk patients need revascularision. Conclusion: It is necessary to make risk stratification for non ST - T elevation ACS to identify high risk lesion and get immediate invasive therapy, but prognostic need further evaluation.