中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
8期
709-711
,共3页
高华炜%郑哲%胡盛寿%徐波
高華煒%鄭哲%鬍盛壽%徐波
고화위%정철%호성수%서파
冠状动脉疾病%预测%死亡
冠狀動脈疾病%預測%死亡
관상동맥질병%예측%사망
Coronary disease%Forecasting%Death
目的 评估欧洲心脏手术风险评估系统(EuroSCORE)Ⅱ对严重冠心病积极治疗后早期死亡的预测价值.方法 2011年7月至2012年9月在阜外心血管病医院连续行择期冠状动脉造影并发现三支病变(合并或不合并左主干病变)患者共2 240例,对其中1 892例进行了积极治疗(经皮冠状动脉介入治疗或冠状动脉旁路移植术)患者的临床资料进行回顾性分析.使用EuroSCOREⅡ分别计算每例积极治疗患者术后30 d的预测病死率,并将患者的平均预测病死率与实际病死率进行比较.采用Hosmer-Lemeshow x2检验评价EuroSCOREⅡ的校准度;采用受试者工作特征(ROC)曲线下面积评价其分辨力(区分死亡和存活病例的能力).结果 患者年龄61.0(54.0 ～68.0)岁,男性占75.8％(1 435/1 892).58.0％的患者(1 097/1 892)进行了经皮冠状动脉介入治疗,42.0％(795/1 892)的患者进行了冠状动脉旁路移植术.术后30 d,共有10例患者死亡,病死率为0.53％(10/1 892).EuroSCOREⅡ预测患者的病死率为0.85％ (95％ CI:0.44％～1.26％),预测病死率的95％CI包含了实际病死率.EuroSCOREⅡ表现出良好的校准度(x2=3.47,P＞0.10)和分辨力(ROC曲线下面积为0.75).结论 对于择期冠状动脉造影发现严重冠心病并进行积极治疗的患者,EuroSCOREⅡ可以较好地预测术后早期死亡.
目的 評估歐洲心髒手術風險評估繫統(EuroSCORE)Ⅱ對嚴重冠心病積極治療後早期死亡的預測價值.方法 2011年7月至2012年9月在阜外心血管病醫院連續行擇期冠狀動脈造影併髮現三支病變(閤併或不閤併左主榦病變)患者共2 240例,對其中1 892例進行瞭積極治療(經皮冠狀動脈介入治療或冠狀動脈徬路移植術)患者的臨床資料進行迴顧性分析.使用EuroSCOREⅡ分彆計算每例積極治療患者術後30 d的預測病死率,併將患者的平均預測病死率與實際病死率進行比較.採用Hosmer-Lemeshow x2檢驗評價EuroSCOREⅡ的校準度;採用受試者工作特徵(ROC)麯線下麵積評價其分辨力(區分死亡和存活病例的能力).結果 患者年齡61.0(54.0 ～68.0)歲,男性佔75.8％(1 435/1 892).58.0％的患者(1 097/1 892)進行瞭經皮冠狀動脈介入治療,42.0％(795/1 892)的患者進行瞭冠狀動脈徬路移植術.術後30 d,共有10例患者死亡,病死率為0.53％(10/1 892).EuroSCOREⅡ預測患者的病死率為0.85％ (95％ CI:0.44％～1.26％),預測病死率的95％CI包含瞭實際病死率.EuroSCOREⅡ錶現齣良好的校準度(x2=3.47,P＞0.10)和分辨力(ROC麯線下麵積為0.75).結論 對于擇期冠狀動脈造影髮現嚴重冠心病併進行積極治療的患者,EuroSCOREⅡ可以較好地預測術後早期死亡.
목적 평고구주심장수술풍험평고계통(EuroSCORE)Ⅱ대엄중관심병적겁치료후조기사망적예측개치.방법 2011년7월지2012년9월재부외심혈관병의원련속행택기관상동맥조영병발현삼지병변(합병혹불합병좌주간병변)환자공2 240례,대기중1 892례진행료적겁치료(경피관상동맥개입치료혹관상동맥방로이식술)환자적림상자료진행회고성분석.사용EuroSCOREⅡ분별계산매례적겁치료환자술후30 d적예측병사솔,병장환자적평균예측병사솔여실제병사솔진행비교.채용Hosmer-Lemeshow x2검험평개EuroSCOREⅡ적교준도;채용수시자공작특정(ROC)곡선하면적평개기분변력(구분사망화존활병례적능력).결과 환자년령61.0(54.0 ～68.0)세,남성점75.8％(1 435/1 892).58.0％적환자(1 097/1 892)진행료경피관상동맥개입치료,42.0％(795/1 892)적환자진행료관상동맥방로이식술.술후30 d,공유10례환자사망,병사솔위0.53％(10/1 892).EuroSCOREⅡ예측환자적병사솔위0.85％ (95％ CI:0.44％～1.26％),예측병사솔적95％CI포함료실제병사솔.EuroSCOREⅡ표현출량호적교준도(x2=3.47,P＞0.10)화분변력(ROC곡선하면적위0.75).결론 대우택기관상동맥조영발현엄중관심병병진행적겁치료적환자,EuroSCOREⅡ가이교호지예측술후조기사망.
Objective To assess the predict value of European system for cardiac operative risk evaluation (EuroSCORE) Ⅱ on early death in patients with severe coronary artery disease undergoing active treatment.Methods Consecutive 2 240 patients with three-vessel disease (with or without left main disease) diagnosed by elevtive coronary angiogram between July 2011 and September 2012 were screened for this study,data from 1 892 patients who underwent active treatments(percutaneous coronary intervention or coronary artery bypass grafting) were analyzed retrospectivly.The predicted 30 days operative mortality calculated with EuroSCORE Ⅱ was compared with the actual one.The calibration and discrimination of EuroSCORE Ⅱ were tested with Hosmer-Lemeshow x2 test and area under receiver operating characteristic (ROC) curve respectively.Results Age was61.0(54.0-68.0) years old and75.8％ (1 435/1 892) were male in this cohort,58.0％ (1 097/1 892) patients received percutaneous coronary intervention and 42.0％ (795/1 892) patients received coronary artery bypass grafting.The overall 30 days operative mortality was 0.53％ (10/1 892),30 days operative mortality predicted by EuroSCORE Ⅱ was 0.85％ (95％ CI:0.44％-1.26％).The calibration (x2 =3.47 and P ＞ 0.10) and discrimination (area under ROC curve was 0.75) of EuroSCORE Ⅱ were satisfactory.Conclusion EuroSCORE Ⅱ could precisely predict 30 days operative mortality for three-vessel disease patients with or without left main disease undergoing active treatments.
