中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (6): 522-526.doi: 10.12007/j.issn.0258‐4646.2018.06.010

• 论著 • 上一篇    下一篇

休克指数对行经皮冠状动脉介入治疗的急性心肌梗死患者长期预后的预测价值

武佳科, 田春阳, 何东旭, 宋佳, 于彤彤, 孙志军, 孙兆青   

  1. 中国医科大学附属盛京医院心血管内科, 沈阳 110022
  • 收稿日期:2017-11-09 出版日期:2018-06-30 发布日期:2018-05-29
  • 通讯作者: 孙兆青 E-mail:sunzhaoqing@vip.163.com
  • 作者简介:武佳科(1994-),男,硕士研究生.
  • 基金资助:
    辽宁省社会发展攻关计划(2011225020)

Predictive Value of Shock Index in Long-term Prognosis of Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

WU Jiake, TIAN Chunyang, HE Dongxu, SONG Jia, YU Tongtong, SUN Zhijun, SUN Zhaoqing   

  1. Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang 110022, China
  • Received:2017-11-09 Online:2018-06-30 Published:2018-05-29

摘要: 目的 探讨休克指数(SI)对行经皮冠状动脉介入治疗的急性心肌梗死患者长期预后的预测价值。方法 连续入选行经皮冠状动脉介入治疗的急性心肌梗死患者1 864例。基于受试者工作特征曲线确定的最佳界值将患者分为低SI组(n=564,SI ≤ 0.51)和高SI组(n=1 300,SI>0.51)。通过COX回归分析研究SI对此类患者长期预后的影响。结果 高SI组入院心功能Ⅲ/Ⅳ级患者比例高于低SI组。术后随访显示,高SI组与低SI组比较,全因死亡率及心源性死亡率更高。多因素COX回归分析显示,SI是行经皮冠状动脉介入治疗的急性心肌梗死患者全因死亡及心源性死亡的独立预测因子。结论 SI是预测行经皮冠状动脉介入治疗的急性心肌梗死患者长期预后的一项简单有效的临床指标,SI>0.51的患者长期预后较差。

关键词: 急性心肌梗死, 经皮冠状动脉介入治疗, 休克指数, 预后, 主要心血管不良事件

Abstract: Objective To investigate the predictive value of shock index(SI) in the long-term prognosis of patients with acute myocardial infarction(AMI) undergoing percutaneous coronary intervention(PCI). Methods A total of 1 864 patients suffering from AMI treated by PCI was enrolled in the study. On the basis of the optimal threshold of the ROC, the patients were divided into low SI group(n=564, SI ≤ 0.51) and high SI group(n=1 300, SI>0.51). The predictive value of SI in long-term prognosis of AMI patients undergoing PCI was then analyzed by COX regression analysis. Results The heart function classification grades Ⅲ/Ⅳ in the SI > 0.51 group were significantly higher than in the SI ≤ 0.51 group. Patients in the high SI group had a higher incidence of all-cause mortality and cardiac mortality during follow-up. Multivariate COX analysis indicated that SI was an independent risk predictor for all-cause mortality and cardiac mortality in such patients. Conclusion SI is a simple and effective clinical index for predicting the long-term prognosis of patients with AMI undergoing PCI with a significant increase in mortality and poor long term prognosis, when the SI is over 0.51.

Key words: acute myocardial infarction, percutaneous coronary intervention, shock index, prognosis, major adverse cardiovascular events

中图分类号: 

  • R587
[1] 陈伟伟. 中国心血管病报告2015[J]. 中华医学信息导报,2016,31(12):11. DOI:10.3969/j.issn.1007-5410.2016.04.001.
[2] 国家卫生计生委合理用药专家委员会,中国药师协会. 急性ST段抬高型心肌梗死溶栓治疗的合理用药指南[J]. 中国医学前沿杂志,2016,8(8):25-41. DOI:10.3969/j.issn.1674-7372.2016.08.007.
[3] GRANGER CB,GOLDBER R J,DABBOUS O,et al. Predictors of hospital mortality in the global registry of acute coronary events[J]. Arch Intern Med,2003,163(19):2345-2353. DOI:10.1001/archinte. 163.19.2345.
[4] GUO ZJ,LIN Q,ZI XR,et al. Correlation of computed tomography angiography parameters and shock index to assess the transportation risk in aortic dissection patients[J]. Radiol Med,2015,120(4):386-392. DOI:10.1007/s11547-014-0463-3.
[5] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 急性心肌梗死诊断与治疗指南[J]. 中华心血管病杂志,2001,16(12):710-725. DOI:10.3760/j:issn:0253-3758.2001.12.004.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 经皮冠状动脉介入治疗指南[J]. 中华心血管病杂志,2009,38(8):675-690. DOI:10.3760/cma.j.issn.0253-3758.2009.01.003.
[7] TESAK M,KALA P,JARKOVSKY J,et al. The value of novel invasive hemodynamic parameters added to the TIMI risk score for shortterm prognosis assessment in patients with ST segment elevation myocardial infarction[J]. Int J Cardiol,2016,214:235-240. DOI:10.1016/j.ijcard.2016.03.073.
[8] CUTLIP DE,WINDECKER S,MEHRAN R,et al. Academic research consortium,clinical end points in coronary stent trials:a case for standardized definitions[J]. Circulation,2007,115(17):2344-2351. DOI:10.1161/CIRCULATIONAHA.106.685313.
[9] D'Ascenzo F,BIONDI-ZOCCAI G,MORETTI C,et al. TIMI, GRACE and alternative risk scores in acute coronary syndromes:a meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients[J]. Contemp Clin Trials, 2012,33(3):507-514. DOI:10.1016/j.cct.2012.01.001.
[10] ARAGAM KG,TAMHANE UU,KLINE-ROGERS E,et al. Does simplicity compromise accuracy in ACS risk prediction a retrospective analysis of the TIMI and GRACE risk scores[J]. PLoS One, 2009,4(11):7947. DOI:10.1371/journal.pone.0007947.
[11] ALLGÖWER M,BURRI C. Shock index[J]. Dtsch Med Wochenschr,1967,92(43):1947-1950.
[12] RICHESSON RL,SUTPHEN R,SHEREFF D,et al. The Rare Diseases Clinical Research Network Contact Registry update:features and functionality[J]. Contemp Clin Trials,2012,33(4):647-656. DOI:10.1016/j.cct.2012.02.012.
[13] RASSAMEEHIRAN S,TEERAKANOK J,SUCHARTLIKITWONG S,et al. Utility of the shock index for risk stratification in patients with acute upper gastrointestinal bleeding[J]. South Med J,2017, 110(11):738-743. DOI:10.14423/SMJ.0000000000000729.
[14] SPYRIDOPOULOS I,NOMAN A,AHMED J,et al. Shock index as a novel predictor of long-term outcome following primary percutaneous coronary intervention[J]. Eur Heart J Acute Cardiovasc Care,2014, 4(3):270-277. DOI:10.1177/2048872614561480.
[15] BILKOVA D,MOTOVSKA Z,WIDIMSKY P,et al. Shock index:a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction[J]. Can J Cardiol,2011,27(6):739-742. DOI:10.1016/j.cjca.2011.07.008.
[16] HUANG B,YANG Y,ZHU J,et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction[J]. Am J Cardiol,2014, 114(9):1315-1321. DOI:10.1016/j.amjcard.2014.07.062.
[17] GRAHAM LN,SMITH PA,STOKER JB,et al. Sympathetic neural hyperactivity and its normalization following unstable angina and acute myocardial infarction[J]. Clin Sci(Lond),2004,106(6):605-611. DOI:10.1042/CS20030376.
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