ST段抬高型心肌梗死患者D-二聚体与GRACE评分的关系

目的：探讨ST段抬高型心肌梗死（STEMI）患者血浆D-二聚体水平与全球急性冠状动脉事件注册（GRACE）评分的关系。方法：选择2013年1月——2014年6月在我科住院的急性ST段抬高型心肌梗死患者81例，入院后立即测定血浆D-二聚体浓度（采血时间距发病2 h-72 h），计算GRACE 评分并进行危险分层，分析STEMI患者血浆D-二聚体水平与GRACE评分及危险分层的关系。结果：根据GRACE评分将所有STEMI患者作危险分层，高危组患者D-二聚体含量的平方根明显高于中危组及低危组（P均＜0.01），中危组与低危组D-二聚体含量的平方根差异无统计学意义（P＞0.05）。将所有患者按D-二聚体含量的高低分为高DD组和低DD组，高DD组患者GRACE评分明显高于低DD组（P＜0.01）。STEMI患者D-二聚体的平方根与GRACE评分呈正相关（r=0. 457，P＜0.01）。结论：STEMI患者血浆D-二聚体水平越高，GRACE评分越高，两者具有良好的相关性。D-二聚体检测对于STEMI患者的危险分层具有参考意义。

Correlation between the D-dimer and GRACE risk score in patients with ST-segment elevation acute coronary syndrome

Objective To study the relationship between plasma D-dimer level obtained on admission and global registry of acute coronary events (GRACE) risk scores in patients with ST-segment elevation myocardial infarction (STEMI). Methods From January 2013 to June 2014, 81 STEMI patients admitted in our hospital were enrolled. On admission (2h-72h since onset) plasma D-dimer was measured in all patients and the GRACE risk score was used for risk stratification. Analyze the relationship between D-dimer level and GRACE risk score as well as risk stratification in STEMI patients. Results According to GRACE risk stratification, the square root of D-dimer of high-risk group was the highest among the three groups (P < 0.01). The GRACE risk score in patients of high D-dimer levels was significantly increased compared with patients of low D-dimer levels (P < 0.01). The square root of D-dimer in STEMI patients had positive correlation with the GRACE risk score (r = 0. 457, P < 0.01). Conclusion Increased plasma D-dimer level was associated with increased GRACE risk score in STEMI patients. Measuring D-dimer level is valuable for risk stratification in STEMI patients.