GRACE风险评分联合外周血红细胞分布宽度对急性冠脉综合征的预后价值.docVIP

GRACE风险评分联合外周血红细胞分布宽度对急性冠脉综合征的预后价值 　　[摘要] 目的 评价全球急性冠状动脉事件注册（GRACE）风险评分联合红细胞分布宽度（RDW）对急性冠脉综合征（ACS）患者预后的价值。 方法 检测110例ACS患者入院时的RDW并进行标准GRACE风险评分，观察RDW和GRACE风险评分对其30 d心血管疾病（CVD）病死率的影响。 结果 110例ACS患者RDW值为（13.75±0.83），死亡者RDW值（14.81±0.94）明显高于幸存者（13.15±0.73），差异有高度统计学意义（P 0.01）。高GRACE评分与CVD病死率密切相关（HR=1.006，P 0.01）。多变量COX风险比例回归模型分析显示，RDW是CVD的独立危险因素（HR=2.282，P 0.01）。将RDW作为单一危险因素加入GRACE风险评分中，RDW是独立于GRACE风险评分中其他各项指标的CVD高危预警指标。GRACE风险评分的曲线下面积（AUC）为0.855，RDW的AUC为0.843，GRACE风险评分联合RDW的AUC为0.925。 结论 RDW水平和GRACE风险评分对30 d CVD病死率具有相似的预测价值，GRACE风险评分联合RDW可提高对ACS 30 d CVD病死率的预测价值。 　　[关键词] 急性冠脉综合征；GRACE风险评分；红细胞分布宽度 　　[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2014）01（c）-0027-03 　　The prognostic value of GRACE risk score combined with red cell distribution width of peripheral blood in patients with acute coronary syndrome 　　ZHAO Ping WANG Yunqiang HU Jiangtao 　　Department of Cardiology Internal Medicine， the Sceond Hospital of Qinhuangdao City， Hebei Province， Qinhuangdao 066600， China 　　[Abstract] Objective To evaluate the prognostic value of global acute coronary event registration （GRACE） risk score combined with red blood cell distribution width （RDW） of peripheral blood in patients with acute coronary syndrome （ACS）. Methods RDW and standard GRACE risk scores of 110 patients with ACS were detected， the influence of RDW and GRACE risk score to its 30 d cardiovascular disease （CVD） mortality were observed. Results RDW value of 110 patients with ACS was （13.75±0.83）， RDW of the death of （14.81±0.94） was significantly higher than that of the survivors （13.15±0.73）， the differences were high statistically significant （P 0.01）. mortality of CVD was closely related with high GRACE score （HR=1.006， P 0.01）. Multivariate Cox proportional hazards regression model analysis showed RDW was an independent risk factor of CVD （HR=2.282， P 0.01）. RDW as a single risk factors added to the GRACE risk score， RDW was a high-risk early warning indicator of CVD independent of the other indicato