广东医学
廣東醫學
엄동의학
Guangdong Medical Journal
2015年
16期
2507-2510
,共4页
冠状动脉粥样硬化%急性冠脉综合征%冠状动脉危险因素%GRACE评分
冠狀動脈粥樣硬化%急性冠脈綜閤徵%冠狀動脈危險因素%GRACE評分
관상동맥죽양경화%급성관맥종합정%관상동맥위험인소%GRACE평분
coronary atherosclerosis%acute coronary syndrome%cardiovascular risk factors%the global registry of acute coronary event score
目的：探讨急性冠脉综合征患者GRACE评分与冠心病危险因素的关系。方法符合标准急性冠脉综合征的患者共692例，根据GRACE评分分为3组：低危组（220例）、中危组（240例）、高危组（232例）。对GRACE评分与冠心病危险因素进行单因素及多因素logistic分析。结果单因素分析结果显示，急性冠脉综合征危险程度越高，GRACE评分越高，存在单个危险因素如高龄、高血压史、吸烟史、男性的患者比例越高， CysC、Fib、Hcy、ApoB、ApoB／ApoA水平越高， ApoA水平越低。多因素分析结果提示， Fib、ApoB／ApoA、 Hcy、CysC、高龄、男性、高血压病史为急性冠脉综合征危险程度加重的独立因素，其中Fib（B＝2.09，P＜0.001）及高龄（B＝1.88，P＜0.001）。结论急性冠脉综合征患者危险程度与多种因素有关，其中Fib、高龄相关性最为显著。在急性冠脉综合征患者中联合运用这些危险因素可能对早期危险分层预后评估及诊疗方案的选择有重要临床参考价值。
目的：探討急性冠脈綜閤徵患者GRACE評分與冠心病危險因素的關繫。方法符閤標準急性冠脈綜閤徵的患者共692例，根據GRACE評分分為3組：低危組（220例）、中危組（240例）、高危組（232例）。對GRACE評分與冠心病危險因素進行單因素及多因素logistic分析。結果單因素分析結果顯示，急性冠脈綜閤徵危險程度越高，GRACE評分越高，存在單箇危險因素如高齡、高血壓史、吸煙史、男性的患者比例越高， CysC、Fib、Hcy、ApoB、ApoB／ApoA水平越高， ApoA水平越低。多因素分析結果提示， Fib、ApoB／ApoA、 Hcy、CysC、高齡、男性、高血壓病史為急性冠脈綜閤徵危險程度加重的獨立因素，其中Fib（B＝2.09，P＜0.001）及高齡（B＝1.88，P＜0.001）。結論急性冠脈綜閤徵患者危險程度與多種因素有關，其中Fib、高齡相關性最為顯著。在急性冠脈綜閤徵患者中聯閤運用這些危險因素可能對早期危險分層預後評估及診療方案的選擇有重要臨床參攷價值。
목적：탐토급성관맥종합정환자GRACE평분여관심병위험인소적관계。방법부합표준급성관맥종합정적환자공692례，근거GRACE평분분위3조：저위조（220례）、중위조（240례）、고위조（232례）。대GRACE평분여관심병위험인소진행단인소급다인소logistic분석。결과단인소분석결과현시，급성관맥종합정위험정도월고，GRACE평분월고，존재단개위험인소여고령、고혈압사、흡연사、남성적환자비례월고， CysC、Fib、Hcy、ApoB、ApoB／ApoA수평월고， ApoA수평월저。다인소분석결과제시， Fib、ApoB／ApoA、 Hcy、CysC、고령、남성、고혈압병사위급성관맥종합정위험정도가중적독립인소，기중Fib（B＝2.09，P＜0.001）급고령（B＝1.88，P＜0.001）。결론급성관맥종합정환자위험정도여다충인소유관，기중Fib、고령상관성최위현저。재급성관맥종합정환자중연합운용저사위험인소가능대조기위험분층예후평고급진료방안적선택유중요림상삼고개치。
Objective To investigate the correlation between the global registry of acute coronary event ( GRACE) score and cardiovascular risk factors in patients with acute coronary syndrome ( ACS) .Methods A total of 692 patients who met the diagnostic criteria of ACS were selected divided into 3 treatment groups, 220 cases in the low risk group, 240 cases in the intermediate risk group, 232 cases in the high risk group.Correlation between the GRACE score and cardiovascular risk factors was analyzed by both univariate and multivariate binary logistic regression.Results Uni-variate logistic regression demonstrated that higher ACS risk was correlated with higher GRACE score, larger proportion of patients having one of the cardiovascular risk factors, e.g.old age, hypertension, male and smoking, elevated levels of cysC, Fib, Hcy, ApoB and ApoB/ApoA, and lower ApoA level.Multivariate logistic regression showed that Fib, ApoB/ApoA, Hcy, CysC, old age, male and hypertension were independent risk factors which aggravate the risk of ACS.Among them, Fib (B=2.091, P<0.001) and old age (B=2.091, P<0.001) were two most prominent risk factors for ACS. Conclusion ACS risk was related to various risk factors, among which Fib and old age were two most prominent inde-pendent risk factors for ACS.Combined application of these indices in ACS patients may have important clinical value in early risk stratification, evaluation of prognosis and decision of treatment options.
