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目的:比较两种不同评分方法(GRACE评分、SYNTAX评分)对冠脉3支病变(3VD)患者1年终点事件(即心源性死亡、再发心梗和需再次血运重建)发生率预测的价值,为临床选择合理治疗方案提供参考。方法:运用SPSS软件对46例2012年3月-2013年2月本院经冠状动脉造影诊断为3支病变的患者进行回顾性分析。根据入院时患者的一般情况、临床生化指标、心电图等结果以及冠脉造影报告,对每例患者分别进行GRACE评分和SYNTAX评分,并依据分值进行相关分组,采用连续校正卡方检验和Fisher’s精确检验比较各组终点事件的发生率。绘制两种不同评分方法受试者工作特征曲线(ROC),并计算曲线下面积(AUC)。分析比较GRACE评分和SYNTAX评分1年终点事件的预测价值。结果:1GRACE评分和SYNTAX评分不同分组间终点事件发生情况差异均有统计学意义(P<0.01)。2GRACE评分和SYNTAX评分两种方法预测3支病变患者1年终点事件的准确度分别是AUC:0.707,95%CI:0.554-0.859和AUC:0.743,95%CI:0.597-0.890。SYNTAX评分在18.2分时预测1年终点事件敏感度和特异度均较好,分别是0.690和0.750。结论:1SYNTAX评分预测1年终点事件的准确度优于GRACE危险评分。GRACE评分能一定程度预测3支病变患者1年发生终点事件可能,但准确度不高。2SYNTAX评分在18.2分时,预测冠脉3支病变1年终点事件敏感度和特异度均较好,兼有准确性和实用性,可用来指导临床,与GRACE评分比较,在临床工作中SYNTAX评分可作为首选辅助工具。
PURPOSE: To compare the predictive value of one-year end-point events (ie, cardiac death, recurrent myocardial infarction, and revascularization) in patients with 3-vessel coronary artery disease (3VD) with two different grading methods (GRACE score, SYNTAX score) The value of clinical treatment for the selection of a reasonable plan. Methods: 46 cases of 3 lesions diagnosed by coronary angiography in our hospital from March 2012 to February 2013 were retrospectively analyzed by SPSS software. According to the general situation of patients on admission, clinical biochemical indicators, electrocardiogram and other results and coronary angiography report, for each patient were GRACE score and SYNTAX score, and according to score the relevant grouping, using continuous calibration chi-square test and Fisher’s exact Test to compare the incidence of end points in each group. Two different scoring method subjects’ working characteristic curves (ROCs) were plotted and the area under the curve (AUC) was calculated. Analysis and comparison of the predictive value of the GRACE score and SYNTAX score 1-year end point event. Results: There was significant difference between the endpoints of 1GRACE score and SYNTAX score among different groups (P <0.01). The accuracy of 2GRACE score and SYNTAX score in predicting 1-year end-point events of 3 lesions were AUC: 0.707, 95% CI: 0.554-0.859 and AUC: 0.743, 95% CI: 0.597-0.890, respectively. The sensitivity and specificity of the SYNTAX score at 18.2 were better at 1-year endpoints, 0.690 and 0.750, respectively. CONCLUSIONS: 1SYNTAX scores predict the accuracy of the 1-year endpoint to be superior to the GRACE risk score. GRACE score can predict to a certain extent three lesions in patients with end point event may be 1, but the accuracy is not high. 2SYNTAX score of 18.2 points, the prediction of 3-year coronary artery disease end-point sensitivity and specificity of 1 year are good, both accuracy and usefulness, can be used to guide clinical, compared with the GRACE score in the clinical work SYNTAX score Can be used as the preferred aids.