祖凌云,葛洪霞,高炜

• 1:北京大学第三医院心内科
• 2:卫生部心血管分子生物学与调节肽卫生部重点实验室
• 3:分子心血管教育部重点实验室

摘要(Abstract)：

目的探讨SYNTAX积分和Gensini评分对急性ST段抬高心肌梗死(STEMI)患者远期预后的预测价值。方法采用回顾性分析,连续入选2008年1月1日至2009年12月31日因STEMI收入北京大学第三医院心脏重症监护室,经皮冠状动脉介入治疗(PCI)并存活出院的患者共178例,计算SYNTAX积分和Gensini评分,按三分类法将患者分为3组:SYNTAX积分低分组SSlow<10分(49例)、中分组10分≤SSmid<18分(69例)、高分组SShigh≥18分(60例);Gensini评分低分组GSlow<41分(59例)、中分组41分≤GSmid<64分(65例)、高分组GShigh≥64分(54例)。随访其主要不良心血管事件(major adverse cardiac events,MACE),包括全因死亡、非致命性心肌梗死、再次血运重建、再次因心脏病住院的发生率,平均随访(4.7±0.5)年。结果 SYNTAX积分低分、中分及高分组的MACE发生率分别是18.4%、21.7%和45.0%,组间比较差异有显著统计学意义(P=0.004)。Gensini评分低分、中分及高分组的MACE发生率分别是20.3%、33.8%和33.3%,组间比较差异无统计学意义(P=0.186)。Cox多因素分析显示,SYNTAX积分是术后5年发生MACE的独立预测因子(P=0.037),以高分组为参照,中分组发生MACE的风险显著降低(HR 0.42,95%CI 0.21~0.84,P=0.015);而Gensini评分对远期预后无预测价值。结论 SYNTAX积分是STEMI患者远期发生MACE的独立预测因子,而Gensini评分对STEMI患者远期MACE发生率无预测价值。

关键词(KeyWords)： 急性ST段抬高心肌梗死;SYNTAX积分;Gensini评分;主要不良心血管事件

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81300076)

作者(Author): 祖凌云,葛洪霞,高炜

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