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目的:探讨室壁运动积分(WMS)与全球急性冠状动脉事件注册(GRACE)评分对急性心肌梗死(AMI)患者12个月主要不良心血管事件(MACE)的预测效力。方法:连续入选住院的AMI患者237例,发病24h内检测WMS,同时计算GRACE评分。随访12个月,记录MACE发生情况。MACE定为心因性死亡、再发非致命性心肌梗死、严重心力衰竭、恶性心律失常。结果:237例入选患者中,发生MACE 68例,其WMS和GRACE评分均高于非MACE患者(P<0.001)。COX风险回归分析显示,WMS和GRACE评分均是AMI患者12个月MACE发生的独立预测因子(P<0.001)。WMS预测12个月MACE发生的ROC曲线下面积为0.865,GRACE评分预测面积为0.731,两者联合预测面积为0.920。结论:WMS及GRACE评分均是AMI患者12个月MACE的独立预测指标,且两者联合使用可明显提高预测效力。
OBJECTIVE: To investigate the predictive power of major adverse cardiac events (MACE) at 12 months in patients with acute myocardial infarction (AMI) by using wall motion scores (WMS) and the Global Acute Coronary Events Registry (GRACE) score. Methods: A total of 237 consecutive AMI patients were enrolled in this study. WMS was detected within 24 hours of symptom onset and the GRACE score was calculated. Follow up for 12 months, record the occurrence of MACE. MACE as a cause of death, recurrent non-fatal myocardial infarction, severe heart failure, malignant arrhythmia. RESULTS: Of the 237 patients enrolled, 68 were MACE and their WMS and GRACE scores were higher than those without MACE (P <0.001). COX risk regression analysis showed that both WMS and GRACE scores were independent predictors of MACE occurrence at 12 months in AMI patients (P <0.001). WMS predicted that the area under the ROC curve of MACE at 12 months was 0.865, the predicted area of GRACE score was 0.731, and the joint prediction area was 0.920. Conclusion: Both WMS and GRACE scores are independent predictors of 12-month MACE in patients with AMI, and the combination of the two can significantly improve the predictive power.