老年NSTE—ACS患者不同策略与TIMI危险评分的关系.pdfVIP

· 470· Chinese JoumaI of MedicinaI Guide 2007 Volume 9 No．6(Serial No．53) 老年NSTE—ACS患者不同策略与TIMI危险评分的关系 兰丽辉 郑刚 (天津市第三医院心内科，天津300250) 【摘要】目的：探讨老年非sT段抬高急性冠脉综合征(NSTE—ACS)患者不同治疗策略与心肌梗死溶栓试验(TIMI)危险 评分的关系。方法：将2003年8月至2005年5月老年NSTE—ACS患者共242例，随机分为早期保守治疗组和早期有创 干预组，再根据TIMI危险评分分为低分组、中分组、高分组。随访30天与6个月的复合心血管事件，评价不同TIMI危险 评分对两种治疗措施的影响。结果：早期有创干预组随访30天及6个月复合心血管事件减少(P0．05)，早期有创干预 组随访30天及6个月，ⅡMI危险评分高分组、中分组患者复合心血管事件发生率明显低于随访同期早期保守治疗组(P 0．05)，但低分组间患者复合心血管事件发生率差异无统计学意义 (P0．05)。结论：在TIMI危险评分高及中分组 NSTE—ACS患者中，早期有创干预较保守治疗组能显著降低心血管事件，改善预后。 、 【关键词】急性冠脉综合征；危险因素；预后 【中图分类号】R541．4 【文献标识码】A 【文章编号】1009—0959(2007)06一o470—02 nle Relationship between Tn缸Risk Score and Efficacy of Conservative or Interventional Strategy in Old Patients with N 一ACS I_anLi—hui，Zheng Gang (Department of Cardiology，Tianjin Third Hospital，Tianjin 300250，China) 【ABSTRACT】Objective：To investigate the relationship between thrombolysis in myocardial infaction(TIMI)risk score and efficacy of different treatment strategies in old patients with non ST—segment elevation acute coronary syndromes(NSTE—ACS)．Methods：From Aug．2003toMay 2005．242oldpatientswithNSTE—ACSwere randomlyassignedtoearly conservative strategyorearlyinvasive strate- gYgroup．Furthermore，low，moderateandlligh，ⅡMIrisk scorewere d nedaccordingtotheTIMI risk score．Thecombined cardi0vascii- lar events were analyzed within follow—uD 30 days and 6 months and related to the，ⅡMI risk scOre at admission．Results：The Comb ined c,,n-diovascularevents of30days and 6monthswere singificantlylowerin earlyinvasive strategy group comparedwith early conservative strategy group．It dicated that early conservative strategy could decreas