北京大学学报(医学版)
北京大學學報(醫學版)
북경대학학보(의학판)
Journal of Peking University (Health Sciences)
2015年
5期
769-773
,共5页
于婕%万峰%解基严%吴松%崔仲奇%徐敏%张喆%高炜
于婕%萬峰%解基嚴%吳鬆%崔仲奇%徐敏%張喆%高煒
우첩%만봉%해기엄%오송%최중기%서민%장철%고위
冠状动脉分流术%治疗结果%生活质量%心脏外科手术
冠狀動脈分流術%治療結果%生活質量%心髒外科手術
관상동맥분류술%치료결과%생활질량%심장외과수술
Coronary artery bypass%Treatment outcome%Quality of life%Cardiac surgical procedures
目的:探讨欧洲心脏外科手术风险评估系统( European system for cardiac operative risk evaluation , EuroSCORE)与中国冠状动脉旁路移植手术评分系统(sino system for coronary operative risk evaluation , SinoSCORE)对冠状动脉旁路移植术后患者早期生命质量的预测价值。方法:连续选择2010年3月至2013年1月在北京大学第三医院心外科接受冠状动脉旁路移植术的218例患者,术前分别以EuroSCORE 和SinoSCORE进行手术风险评价,术前及术后3个月以简明健康调查量表进行生命质量调查,分析不同评分系统对术后早期生命质量的预测价值。校准度采用Hosmer-Lemeshow拟合优度检验评价,分辨力采用ROC曲线下面积( AUC)评价。结果:除疼痛与心理功能两个维度外,患者的手术风险评分与术后早期生命质量存在一定相关性( r=-0.493~-0.203,P<0.05)。 Logistic回归显示,患者手术风险评分高是术后生命质量低于平均水平的危险因素(OR>1.0,P<0.05),并且EuroSCORE 的OR值高于SinoSCORE。 SinoSCORE 模型Hosmer-Lemeshow 拟合优度检验P=0.628,AUC=0.754;EuroSCORE 模型 Hosmer-Lemeshowrny 拟合优度检验 P =0.538, AUC =0.854。结论:EuroSCORE 和SinoSCORE对冠状动脉旁路移植术患者术后早期生命质量的某些方面具有一定的预测价值,并且EuroSCORE的预测价值可能更高。
目的:探討歐洲心髒外科手術風險評估繫統( European system for cardiac operative risk evaluation , EuroSCORE)與中國冠狀動脈徬路移植手術評分繫統(sino system for coronary operative risk evaluation , SinoSCORE)對冠狀動脈徬路移植術後患者早期生命質量的預測價值。方法:連續選擇2010年3月至2013年1月在北京大學第三醫院心外科接受冠狀動脈徬路移植術的218例患者,術前分彆以EuroSCORE 和SinoSCORE進行手術風險評價,術前及術後3箇月以簡明健康調查量錶進行生命質量調查,分析不同評分繫統對術後早期生命質量的預測價值。校準度採用Hosmer-Lemeshow擬閤優度檢驗評價,分辨力採用ROC麯線下麵積( AUC)評價。結果:除疼痛與心理功能兩箇維度外,患者的手術風險評分與術後早期生命質量存在一定相關性( r=-0.493~-0.203,P<0.05)。 Logistic迴歸顯示,患者手術風險評分高是術後生命質量低于平均水平的危險因素(OR>1.0,P<0.05),併且EuroSCORE 的OR值高于SinoSCORE。 SinoSCORE 模型Hosmer-Lemeshow 擬閤優度檢驗P=0.628,AUC=0.754;EuroSCORE 模型 Hosmer-Lemeshowrny 擬閤優度檢驗 P =0.538, AUC =0.854。結論:EuroSCORE 和SinoSCORE對冠狀動脈徬路移植術患者術後早期生命質量的某些方麵具有一定的預測價值,併且EuroSCORE的預測價值可能更高。
목적:탐토구주심장외과수술풍험평고계통( European system for cardiac operative risk evaluation , EuroSCORE)여중국관상동맥방로이식수술평분계통(sino system for coronary operative risk evaluation , SinoSCORE)대관상동맥방로이식술후환자조기생명질량적예측개치。방법:련속선택2010년3월지2013년1월재북경대학제삼의원심외과접수관상동맥방로이식술적218례환자,술전분별이EuroSCORE 화SinoSCORE진행수술풍험평개,술전급술후3개월이간명건강조사량표진행생명질량조사,분석불동평분계통대술후조기생명질량적예측개치。교준도채용Hosmer-Lemeshow의합우도검험평개,분변력채용ROC곡선하면적( AUC)평개。결과:제동통여심리공능량개유도외,환자적수술풍험평분여술후조기생명질량존재일정상관성( r=-0.493~-0.203,P<0.05)。 Logistic회귀현시,환자수술풍험평분고시술후생명질량저우평균수평적위험인소(OR>1.0,P<0.05),병차EuroSCORE 적OR치고우SinoSCORE。 SinoSCORE 모형Hosmer-Lemeshow 의합우도검험P=0.628,AUC=0.754;EuroSCORE 모형 Hosmer-Lemeshowrny 의합우도검험 P =0.538, AUC =0.854。결론:EuroSCORE 화SinoSCORE대관상동맥방로이식술환자술후조기생명질량적모사방면구유일정적예측개치,병차EuroSCORE적예측개치가능경고。
Objective:To investigate the predicting value of European system for cardiac operative risk evaluation ( EuroSCORE ) and sino system for coronary operative risk evaluation ( SinoSCORE ) in early quality of life of patients after coronary artery bypass surgery (CABG).Methods:A total of 218 consecu-tive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation .Health related quality of life ( QoL) was estimated by using 36-item short form health survey ( SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two sys -tems in early post-operative QoL.Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test. Discrimination was tested by determining the area under the receiver operating characteristic ( ROC ) curve .Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively ,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P<0.001).Except for bodily pain (BP) and mental health (MH), statistically significant correlation was found between the preoperative risk evaluation scores and the postoperative QoL scores (r:-0.203 to -0.493, P<0.05). Logistic regression analyses indicated that both the scores emerged as the independent predictor for a relatively worse QoL ( OR>1 , P<0 .05 ) .Furthermore , the EuroSCORE predicted the outcome with a higher OR.For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754.For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854.Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL , while EuroSCORE might have a greater predicting value.