尾加压素Ⅱ水平及危险评分对非心肌梗死患者的预后判断价值

目的:通过一项5年的随访初步探讨尾加压素Ⅱ(UⅡ)水平对非心肌梗死冠心病患者的预后判断价值,并同传统的危险评分作比较。方法:入选冠脉造影确诊冠心病的非心梗患者共84例,每年电话随访并查阅门诊病历,记录每名患者5年内的再发缺血或再次血管重建事件,心脏事件(心绞痛、心梗、心衰),脑血管事件,死亡,总事件率等。UⅡ水平>2.8ng/ml计19例。EUROPA危险评分≥10,为高危(n=9)。结果:列入统计的84例患者,全部完成9个月随访,完成5年随访75例(随访率90%),平均随访时间为4.8年,在UⅡ高水平组仅脑梗死率升高(10.5%vs0%,P<0.05),总事件率等未见统计学的差异(23.8%vs18.5%)。高危险评分组总事件率、死亡率均较低分组显著升高(44.6%vs26.7%,22.2%vs3.0%,P<0.05),脑梗死及再次血管重建率虽然也增高,但无统计学差异(P>0.05)。结论:在非心肌梗死冠心病患者,基础UⅡ水平高者可能脑梗死发生率较高,其他的事件率包括总事件、死亡、再次血管重建等均未见到UⅡ的预测价值。

Value of urotensin lI and risk score on the prognosis for non- infarction coronary heart disease patients

Objective:A five-year follow up research was performed to find the value of urotensin Ⅱ(UⅡ)on the prognostic for non-infarction coronary heart disease(CHD)patients,and compare with traditional risk score.Methods:Eighty four CHD patients with angiographic evidence were enrolled,the event of cardiovascular disease such as re-ischemia or revasculation,heart failure,stroke or death were checked every year by call or refer the outpatient record.Nineteen of them had higher UⅡ(>2.8ng/ml,referred by normal people)and 9 of the them EUROPA risk score≥10.Results:All 84 patients completed 9 months follow-up,75 of them completed 5 years follow-up,whose mean time was 4.8 years.Only the cerebral infarction rate was higher(10.5%vs0%,P<0.05)in the high UⅡ patients,while the other indexes including the total event rate had no difference.In high risk score patients,the total event and death rate were higher(44.6%vs26.7%,22.2%vs3.0%,P<0.05),the cerebral infarction or revasculation rate increased without significant difference.Conclusion:In non-infarction CHD patients,a higher UⅡ means a high cerebral infarction rate other than total events,death or revasculation.