GRACE与TIMI危险评分对急性冠脉综合征患者危险分层的对比研究

目的 对比全球急性冠状动脉事件注册（GRACE）与心肌梗死溶栓疗法 （TIMI）危险评分对急性冠脉综合征（ACS ）患者危险分层应用价值。 方法采用病例-对照回顾性研究方法，收集2008年8月至2009年8月急诊入院的ACS患者416例，对其分别进行GRACE和TIMI危险评分，以评分差异分组，分析不同组别患者发病后30d和1年内心血管事件发生情况与危险评分之间的关系，比较两种评分系统对发病30d和1年内发生心血管事件患者的识别能力。 结果两种评分系统对发病30d内和1年内发生心血管事件ACS患者具有较高的分辨能力， 两者差异无统计学意义（P>0.05）。结论 GRACE和TIMI危险评分对急性冠脉综合征患者危险分层和预后评价上具有一致性，TIMI危险评分更适用于急诊科。

Significance of detecting GRACE and TIMI scores for risk stratification and prognosis in patients with acute coronary syndrome

Objective To compare GRACE and TIMI scores for risk stratification and prognosis in patients with acute coronary syndrome (ACS), and investigate the predictive significance of these methods. Methods A total of 416 patients with ACS were collected during August 2008 to August 2009 in Qilu Hospital of Shandong University for a retrospective case-control study. The GRACE and TIMI scores were recorded and evaluated to analyze the association between incidence of cardiovascular events 30 days and 1 year after the attack and risk scores. Results The patients with higher GRACE and TIMI scores had higher incidence of cardiovascular events in 30 days and one year. In particular, the patients with GRACE score > 133 and TIMI score ≥ 10 had significantly increased rate of cardiovascular events. There was no significance between the two methods (P>0.05) in predicting high-risk patients. Conclusion GRACE score and TIMI score are of the same predictive value in risk stratification of ACS patients.