中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
10期
1024-1026
,共3页
急性心肌梗死%APACHEⅡ评分%危险分层
急性心肌梗死%APACHEⅡ評分%危險分層
급성심기경사%APACHEⅡ평분%위험분층
Acute myocardial infarction%APACHE Ⅱ score%Risk stratification
目的 探讨APACHEⅡ评分在急性心肌梗死患者危险分层中的临床意义.方法 2011年1月至2012年12月我院心内科连续住院资料完整的急性心肌梗死患者142例,入院24h进行APACHEⅡ评分并分组,比较高危组(34例)与低危组(108例)1年内随访的差异.结果 高危组年龄显著较低危组大,分别为(78.9±8.1)岁与(65.8±10.2)岁(t=6.835,P＜0.001),高危组心功能KillipⅢ级和Ⅳ级患者比低危组多,分别为10例(29.4％)与2例(1.8％),6例(17.6％)与0例(x2值分别为21.950、15.777,P均＜0.05),肌酸激酶同工酶和肌钙蛋白Ⅰ的峰值高危组较低危组高,分别为(147.7±21.5) U/L与(105.5±17.6) U/L,(42.9±6.3)μg/L与(36.5±5.4) μg/L(t值分别为11.541、5.785,P均＜0.001),心脏事件(心力衰竭、恶性心律失常,非致死性心肌梗死和任何原因的死亡)的发生率高危组比低危组高,分别为58.8％(20/34)与29.6％(32/108),47.0％(16/34)与3.7％ (4/108),17.6％ (6/34)与6.4％ (7/108),17.6％(6/34)与6.4％ (7/108),差异均有统计学意义(x2值分别为8.274、36.665、3.876、3.876,P均＜0.05).结论 APACHEⅡ评分可以作为一种简单、可靠、实用的急性心肌梗死患者危险分层方法用于临床.
目的 探討APACHEⅡ評分在急性心肌梗死患者危險分層中的臨床意義.方法 2011年1月至2012年12月我院心內科連續住院資料完整的急性心肌梗死患者142例,入院24h進行APACHEⅡ評分併分組,比較高危組(34例)與低危組(108例)1年內隨訪的差異.結果 高危組年齡顯著較低危組大,分彆為(78.9±8.1)歲與(65.8±10.2)歲(t=6.835,P＜0.001),高危組心功能KillipⅢ級和Ⅳ級患者比低危組多,分彆為10例(29.4％)與2例(1.8％),6例(17.6％)與0例(x2值分彆為21.950、15.777,P均＜0.05),肌痠激酶同工酶和肌鈣蛋白Ⅰ的峰值高危組較低危組高,分彆為(147.7±21.5) U/L與(105.5±17.6) U/L,(42.9±6.3)μg/L與(36.5±5.4) μg/L(t值分彆為11.541、5.785,P均＜0.001),心髒事件(心力衰竭、噁性心律失常,非緻死性心肌梗死和任何原因的死亡)的髮生率高危組比低危組高,分彆為58.8％(20/34)與29.6％(32/108),47.0％(16/34)與3.7％ (4/108),17.6％ (6/34)與6.4％ (7/108),17.6％(6/34)與6.4％ (7/108),差異均有統計學意義(x2值分彆為8.274、36.665、3.876、3.876,P均＜0.05).結論 APACHEⅡ評分可以作為一種簡單、可靠、實用的急性心肌梗死患者危險分層方法用于臨床.
목적 탐토APACHEⅡ평분재급성심기경사환자위험분층중적림상의의.방법 2011년1월지2012년12월아원심내과련속주원자료완정적급성심기경사환자142례,입원24h진행APACHEⅡ평분병분조,비교고위조(34례)여저위조(108례)1년내수방적차이.결과 고위조년령현저교저위조대,분별위(78.9±8.1)세여(65.8±10.2)세(t=6.835,P＜0.001),고위조심공능KillipⅢ급화Ⅳ급환자비저위조다,분별위10례(29.4％)여2례(1.8％),6례(17.6％)여0례(x2치분별위21.950、15.777,P균＜0.05),기산격매동공매화기개단백Ⅰ적봉치고위조교저위조고,분별위(147.7±21.5) U/L여(105.5±17.6) U/L,(42.9±6.3)μg/L여(36.5±5.4) μg/L(t치분별위11.541、5.785,P균＜0.001),심장사건(심력쇠갈、악성심률실상,비치사성심기경사화임하원인적사망)적발생솔고위조비저위조고,분별위58.8％(20/34)여29.6％(32/108),47.0％(16/34)여3.7％ (4/108),17.6％ (6/34)여6.4％ (7/108),17.6％(6/34)여6.4％ (7/108),차이균유통계학의의(x2치분별위8.274、36.665、3.876、3.876,P균＜0.05).결론 APACHEⅡ평분가이작위일충간단、가고、실용적급성심기경사환자위험분층방법용우림상.
Objective To explore the clinical significance of APACHE Ⅱ score on risk stratification in patients with acute myocardial infarction.Methods One hundred and forty-two patients with acute myocardial infarction were included in the study who were admitted to hospital consecutively from Jan.2011 to Dec.2012.High risk group and low risk group were divided by the APACHE Ⅱ score.Some clinical variables at the first 24 h after admitted to hospital and occurring during the following 1 year were recorded Results The age in high risk group was 78.9 ±8.1,significantly higher than that in low risk group (65.8 ± 10.2;t =6.835,P ＜ 0.001).The cases with Killip Ⅲ and Ⅳ in high risk group were 10(29.4％) and 2(1.8％),lower than in low risk group (6 (1.8％) and 0 (0％) ; x2 =21.950,15.777 ; P ＜ 0.005).The level of creatine kinase-MB (CK-MB) and cardiac troponin Ⅰ in high risk group were (147.7 ±21.5) U/L and (105.5 ± 17.6) U/L,higher than in low risk group((105.5 ± 17.6) U/L,(42.9 ± 6.3) U/L; t =11.541,5.785 ; P ＜ 0.001).The incidence of severe cardiac events(malignant arrhythmia,heart failure,non fatal myocardial infarction and death from any cause in high risk group were 58.8％ (20/34),47.0％ (16/34),17.6％ (6/34) and 17.6％ (6/34),higher than in low risk group (29.6％ (32/108),3.7％ (4/108),6.4％ (7/108) and 6.4％ (7/108) ; x2 =8.274,36.665,3.876 and 3.876 ; P ＜ 0.05).Conclusion APACHE Ⅱ score is likely to be a simple and practical tool for risk stratification in patients with acute myocardial infarction.
