河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (1): 58-63.doi: 10.3969/j.issn.1007-3205.2024.01.012

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CAMI-STEMI、GRACE评分及WMR与STEMI患者PCI治疗后短期预后的相关性分析

  

  1. 江苏省溧阳市人民医院心血管内科，江苏 溧阳 213300

  • 出版日期:2024-01-25 发布日期:2024-01-31
  • 作者简介:朱苏文（1988-），男，江苏溧阳人，江苏省溧阳市人民医院主治医师，医学学士，从事心血管内科疾病诊治研究。
  • 基金资助:
    江苏省自然科学基金项目（BK20191494）

Correlation analysis between CAMI-STEMI, GRACE score, WMR and short-term prognosis of STEMI patients after PCI

  1. Department of Cardiovascular Medicine, People′s Hospital of Liyang City, Jiangsu Province, Liyang 213300， China

  • Online:2024-01-25 Published:2024-01-31

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摘要： 目的 探讨中国心肌梗死注册登记研究-ST段抬高型心肌梗死（Chinese myocardial infarction registration study-ST segment elevation myocardial infarction，CAMI-STEMI）、全球急性冠状动脉事件注册（global acute coronary event registration，GRACE）评分及白细胞/平均血小板体积（white blood cell/mean platelet volume，WMR）与急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗后短期预后间的相关性。
方法 回顾性分析STEMI患者92例的临床资料。采用多因素Logistic回归分析，明确STEMI患者PCI术后短期预后不良的危险因素。
结果 根据PCI术后院内主要不良心血管事件（major adverse cardiovascular events，MACE）发生情况分为预后良好组（n=60）和预后不良组（n=32）。预后不良组患者ST段下移占比、CAMI-STEMI评分、GRACE评分和WRM水平［14（43.75%）、（6.37±2.15）分、（193.15±20.13）分和（1 654.21±150.54）×10-6/L2］显著高于预后良好组［14（23.33%）、（3.14±1.04）分、（139.23±18.57）分和（1 413.35±118.76）×10-6/L2］，差异有统计学意义（P＜0.05）。受试者工作曲线（ROC）分析显示，CAMI-STEMI、GRACE评分及WMR预测STEMI患者PCI术后短期预后不良的曲线下面积分别为0.967、0.959、0.912（P＜0.05）。多因素Logistic回归分析显示，ST段下移、CAMI-STEMI评分≥4.720分、GRACE评分≥165.605分、WMR≥1 555.770×10-6/L2为STEMI患者PCI术后短期预后不良的危险因素（P＜0.05）。
结论 STEMI患者PCI术后短期预后不良受ST段下移、CAMI-STEMI和GRACE评分及WMR水平影响，且均对STEMI患者短期预后具有较高的预测价值。


关键词: ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 预后

Abstract: Objective To explore the relationship between  the Chinese myocardial infarction registration study-ST segment elevation myocardial infarction (CAMI-STEMI), global registry of acute coronary event (GRACE) score, white blood cell/mean platelet volume (WMR) and the short-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention(PCI). 
 Methods Retrospective analysis was performed on clinical data of 92 STEMI patients. Multivariate logistic regression analysis was used to identify the risk factors for short-term poor prognosis after PCI in STEMI patients. 
 Results According to the incidence of major adverse cardiovascular events (MACE) in the hospital after PCI, patients were divided into a good prognosis group (n=60) and a poor prognosis group (n=32). The proportion of ST segment descent, CAMI-STEMI score, GRACE score, and WRM level in patients with poor prognosis were ［14 (43.75%), (6.37±2.15) points, (193.15±20.13) points, and (1 654.21±150.54)］×10-6/L2］, which were significantly higher than those in good prognosis group ［14 (23.33%), (3.14±1.04) points, (139.23±18.57) points, and (1 413.35±118.76)×10-6/L2］, showing significant difference (P＜0.05). The receiver operating curve (ROC) analysis showed that the area under the ROC curve (AUC) of CAMI-STEMI, GRACE score, and WMR in predicting short-term poor prognosis in STEMI patients after PCI were 0.967, 0.959, and 0.912, respectively (P＜0.05). Multivariate Logistic regression analysis showed that ST segment descent, CAMI-STEMI score ≥4.720 points, GRACE score ≥165.605 points, WMR ≥1 555.770×10-6/L2 were risk factors for short-term poor prognosis of STEMI patients after PCI (P＜0.05). 
 Conclusion The short-term poor prognosis of STEMI patients after PCI is affected by ST segment descent, CAMI-STEMI, GRACE score and WMR level, which have high predictive value for the short-term prognosis of STEMI patients. 


Key words: ST elevation myocardial infarction, percutaneous coronary intervention, prognosis

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