入院时APACHE-Ⅱ评分在急性心肌梗死患者危险分层中的应用价值.pdfVIP

实用诊断与治疗杂志2008年第22卷第3期 · 163 · · 论 著· 入院时APACHE一Ⅱ评分在急性心肌梗死 患者危险分层中的应用价值 俞建华 ，刘新兵 ，方旭成 ，吴炎 ，沈励 ，赵仲谋 ，许其使 (摘要) 目的：探讨入院时APACHE-II评分在急性心肌梗死患者危险分层中的应用价值。方法：根据急性心肌梗 死患者入院时APACHE_Ⅱ评分进行分组，比较高危组与低危组入院时及入院后30 d内随访的差异。结果：(1)高危组 年龄显著较低危组大，差异有统计学意义(PO．05)；(2)高危组糖尿病患者比低危组多，差异有统计学意义(PO．01)； (3)高危组ST段抬高心肌梗死患者显著比低危组多，差异有统计学意义(PO．05)；(4)高危组血TNI水平较低危组高， 差异有统计学意义(PO．05)；(5)高危组30 d内病死率比低危组高，差异有统计学意义(PO．05)。结论：APACHE-II 评分可作为有效的急性心肌梗死患者初期危险分层的手段。 (关键词) 急性心肌梗死；APACHE-II；危险分层 中图分类号：R541．4 文献标识码：A 文章编号：1672 3457(2008)03—163—02 Value of APACHE一Ⅱ score on risk stratification in patients with acute myocardial infarction YU Jianhua，LIU Xinbing，FANG Xucheng，et a1．Cardiology Department，Yangpu District Shidong 1 I Hospital，Shanghai 200438，China (Abstract3 0bjective To assess the value of APACHE—lI score on risk stratification in patients with acute myocardial infarction．Methods High risk group and low risk group were divided by the APACHE一Ⅱ score．Some clinical variables at the first 24 hours after admitted to hospital and occurring during the following 30 days were compared between the two groups．Results(1)The age was significantly higher in high risk group(P0．05)；(2)The patients of diabetes mellitus in high risk group was significant more than in low risk group(P0．01)；(3)The patients of ST—segment elevation myocardial infarction in high risk group was more significantly than in low risk group(P O．O5)；(4)The level of TNI in blood in high risk group was higher than in low risk group(P0．05)； (5)The severe cardiac events occurred frequently in high risk group．Conclusion APACHE一Ⅱscore is an effective method for risk stratificati