目的 探讨心肌梗死溶栓治疗临床试验(thrombolysis in myocardial infarction, TIMI)危险评分对急性心肌梗死(acute myocardial infarction, AMI)患者远期预后的预测价值。方法 采用回顾性分析,收集解放军总医院第三医学中心2014-01-01至2015-12-31收治并且出院后完成3年随访的AMI患者2958例。对每例患者进行TIMI危险评分,记录3年内发生终点事件的情况。结果 不同危险分层的患者3年内终点事件高危患者发生率为99.65%,高于中危患者(35.35%)和低危患者(13.71%),差异有统计学意义(P＜0.05)。不同危险分层的患者3年内病死率高危患者为19.96%,高于中危患者的5.33%和低危患者的1.31%,差异有统计学意义(P＜0.05)。 采用TIMI危险评分预测AMI患者3年内病死率,曲线下面积(area under the curve, AUC)为0.7996, 95%CI为0.7962～0.8030。结论 AMI患者的TIMI危险评分越高,随访3年内终点事件发生率越高,病死率越高,长期预后越差。TIMI危险评分体系是评估AMI患者近期及远期预后的有效工具。
Abstract
Objective To investigate the predictive value of TIMI risk scores for thrombolytic therapy of myocardial infarction in patients with acute myocardial infarction.Methods The present data was obtained from a retrospective analysis. A total of 2958 cases of acute myocardial infarction treated in our hospital between January 1,2014 and December 31,2015 were selected, who completed 3 years of follow-up after discharge. The TIMI risk score was recorded of each patient to follow up on the endpoint events within 3 years.Results The incidence of endpoint events in patients with different risk stratification was compared. The incidence was 99.65% for the high score group, 35.35% for the middle score group, and 13.71% for the low score group, so the difference was statistically significant (P<0.05). The three-year mortality rate of patients with different risk stratification was compared: 19.96% for the high score group, 5.33% for the middle score group and 1.31% for the low score group. The difference was also of statistical significance (P<0.05).The AUC of the TIMI risk score was 0.7996, while 95%CI was 0.7962-0.8030.Conclusions The higher the TIMI risk score in AMI patients, the higher the incidence of endpoint events within 3 years of follow-up, the higher fatality rate and the worse long-term prognosis. TIMI risk scores can effectively help predict the prognosis in patients with AMI.
关键词
TIMI危险评分 /
心肌梗死 /
急性病 /
预后
Key words
TIMI risk score /
myocardial infarction /
acute disease /
prognosis
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参考文献
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