中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2012年
6期
454-457
,共4页
叶慧明%彭建军%任利辉%卢彦娜%姜浩%王萍%徐桂玉%关付%杨水祥
葉慧明%彭建軍%任利輝%盧彥娜%薑浩%王萍%徐桂玉%關付%楊水祥
협혜명%팽건군%임리휘%로언나%강호%왕평%서계옥%관부%양수상
冠心病%血管成形术,经腔,经皮冠状动脉
冠心病%血管成形術,經腔,經皮冠狀動脈
관심병%혈관성형술,경강,경피관상동맥
Coronary disease%Angioplasty,transluminal,percutaneous coronary
目的 比较联用冠状动脉造影和临床特征的整体风险分层系统( Global Risk Classification,GRC)与单纯冠状动脉病变心脏外科与介入治疗狭窄冠状动脉研究(Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery,SYNTAX)评分和临床特征欧洲心脏手术危险评估系统(The European System for Cardiac Operative Risk Evaluation,EuroSCORE)在无保护左主干(ULMCA)病变老年人支架置入术后的预测价值.方法 老年ULMCA病变接受支架术治疗105例,根据有无主要不良心脏事件(MACE)分两组,分析GRC评分与SYNTAX积分和EuroSCORE评估方法对MACE的预测价值.结果 EuroSCORE评分MACE组与非MACE组分别为(2.0±2.3)分和(6.5±2.9)分(t=8.18,P=0.002)；左主干伴3支病变和左主干分叉病变的比例高(x2值分别为8.96、6.96,P值为0.011和0.008)；MACE发生率GRC高危组55.9％(19/34),较中危组20.5％(9/44)和低危组7.4％(2/27)高(x2=19.77,P=0.001).GRC对MACE的预测价值优于SYNTAX积分和EuroSCORE积分,GRC、SYNTAX积分及EuroSCORE的曲线下面积[95％CI分别为0.821(0.730～0.912)、0.586(0.462～0.709)和0.631(0506～0.757)],GRC与SYNTAX 积分和EuroSCORE比较,差异有统计学意义(Z值分别为3.29、2.63,P＜0.01、P＜0.05).结论 GRC评分较SYNTAX积分和EuroSCORE更好的预测ULMCA病变老年患者的MACE.
目的 比較聯用冠狀動脈造影和臨床特徵的整體風險分層繫統( Global Risk Classification,GRC)與單純冠狀動脈病變心髒外科與介入治療狹窄冠狀動脈研究(Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery,SYNTAX)評分和臨床特徵歐洲心髒手術危險評估繫統(The European System for Cardiac Operative Risk Evaluation,EuroSCORE)在無保護左主榦(ULMCA)病變老年人支架置入術後的預測價值.方法 老年ULMCA病變接受支架術治療105例,根據有無主要不良心髒事件(MACE)分兩組,分析GRC評分與SYNTAX積分和EuroSCORE評估方法對MACE的預測價值.結果 EuroSCORE評分MACE組與非MACE組分彆為(2.0±2.3)分和(6.5±2.9)分(t=8.18,P=0.002)；左主榦伴3支病變和左主榦分扠病變的比例高(x2值分彆為8.96、6.96,P值為0.011和0.008)；MACE髮生率GRC高危組55.9％(19/34),較中危組20.5％(9/44)和低危組7.4％(2/27)高(x2=19.77,P=0.001).GRC對MACE的預測價值優于SYNTAX積分和EuroSCORE積分,GRC、SYNTAX積分及EuroSCORE的麯線下麵積[95％CI分彆為0.821(0.730～0.912)、0.586(0.462～0.709)和0.631(0506～0.757)],GRC與SYNTAX 積分和EuroSCORE比較,差異有統計學意義(Z值分彆為3.29、2.63,P＜0.01、P＜0.05).結論 GRC評分較SYNTAX積分和EuroSCORE更好的預測ULMCA病變老年患者的MACE.
목적 비교련용관상동맥조영화림상특정적정체풍험분층계통( Global Risk Classification,GRC)여단순관상동맥병변심장외과여개입치료협착관상동맥연구(Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery,SYNTAX)평분화림상특정구주심장수술위험평고계통(The European System for Cardiac Operative Risk Evaluation,EuroSCORE)재무보호좌주간(ULMCA)병변노년인지가치입술후적예측개치.방법 노년ULMCA병변접수지가술치료105례,근거유무주요불양심장사건(MACE)분량조,분석GRC평분여SYNTAX적분화EuroSCORE평고방법대MACE적예측개치.결과 EuroSCORE평분MACE조여비MACE조분별위(2.0±2.3)분화(6.5±2.9)분(t=8.18,P=0.002)；좌주간반3지병변화좌주간분차병변적비례고(x2치분별위8.96、6.96,P치위0.011화0.008)；MACE발생솔GRC고위조55.9％(19/34),교중위조20.5％(9/44)화저위조7.4％(2/27)고(x2=19.77,P=0.001).GRC대MACE적예측개치우우SYNTAX적분화EuroSCORE적분,GRC、SYNTAX적분급EuroSCORE적곡선하면적[95％CI분별위0.821(0.730～0.912)、0.586(0.462～0.709)화0.631(0506～0.757)],GRC여SYNTAX 적분화EuroSCORE비교,차이유통계학의의(Z치분별위3.29、2.63,P＜0.01、P＜0.05).결론 GRC평분교SYNTAX적분화EuroSCORE경호적예측ULMCA병변노년환자적MACE.
Objective To compare the predicting values for Prognosis among Global Risk Classification (GRS),Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) score,the European System for Cardiac Operative Risk Evaluation (EuroSCORE) in patients who received stenting because of unprotected left main coronary artery (ULMCA) lesion.Methods Totally 105 successive elderly patients with ULMCA lesion who received stenting were divided into 2 groups:with and without main adverse cardiac events (MACE).The clinical and angiographic characteristics were analyzed and then compared among GRC,SYNTAX score and EuroSCORE.Results As compared with none MACE group,MACE group had higher EuroSCORE score (2.0±2.3 vs.6.5±2.9,t=8.18,P=0.002),and more trivessel disease and left main bifurcation lesion (x2 =8.96,6.96,P =0.011,P =0.008).High risk GRC showed more MACE than medium or low risk GRC [55.9％ (19/34) vs.20.5％(9/44),7.4％ (2/27),x2 =19.77,P=0.001].AUC(95％CI )of GRC,SYNTAX score and EuroSCORE were [0.821 (0.730-0.912),0.586(0.462-0.709) and 0.631 (0506-0.757)],respectively.Compared with SYNTAX score and EuroSCORE,GRC was superior in the MACE predicting value (Z=3.29,2.63,P＜0.01 or P＜0.05).
