GRACE 风险评分联合外周血红细胞分布宽度对急性冠脉综合征的预后价 值简

目的评价全球急性冠状动脉事件注册（GRACE）风险评分联合红细胞分布宽度（RDW）对急性冠脉综合征（ACS）患者预后的价值。方法检测110例ACS患者入院时的RDW并进行标准GRACE风险评分，观察RDW和GRACE风险评分对其30d心血管疾病（CVD）病死率的影响。结果110例ACS患者RDW值为（13．75±0．83），死亡者RDW值（14．81±0．94）明显高于幸存者（13．15±0．73），差异有高度统计学意义（P〈0．01）。高GRACE评分与CVD病死率密切相关（HR=1．006，P〈0．01）。多变量COX风险比例回归模型分析显示，RDW是CVD的独立危险因素（HR=2．282，P〈0．01）。将RDW作为单一危险因素加入GRACE风险评分中，RDW是独立于GRACE风险评分中其他各项指标的CVD高危预警指标。GRACE风险评分的曲线下面积（AUC）为0．855，RDW的AUC为0．843，GRACE风险评分联合RDW的4UC为0．925。结论RDW水平和GRACE风险评分对30dCVD病死率具有相似的预测价值．GRACE风险评分联合RDW可提高对ACS30dCVD病死率的预测价值。

The prognostic value of GRACE risk score combined with red cell distribution width of peripheral blood in patients with acute coronary syndrome

Objective To evaluate the prognostic value of global acute coronary event registration （GRACE） risk score combined with red blood cell distribution width （RDW） of peripheral blood in patients with acute coronary syndrome （ACS）. Methods RDW and standard GRACE risk scores of 110 patients with ACS were detected, the influence of RDW and GRACE risk score to its 30 d cardiovascular disease （CVD） mortality were observed. Results RDW value of 110 patients with ACS was （13.75±0.83）, RDW of the death of （14.81±0.94） was significantly higher than that of the sur- vivors （13.15±0.73）, the differences were high statistically significant （P 〈 0.01）. mortality of CVD was closely related with high GRACE score （HR=1.006, P 〈 0.01）. Multivariate Cox proportional hazards regression model analysis showed RDW was an independent risk factor of CVD （HR=2.282, P 〈 0.01）. RDW as a single risk factors added to the GRACE risk score, RDW was a high-risk early warning indicator of CVD independent of the other indicators of GRACE risk score. A UC of GRACE risk score was 0.855, RDW A UC was 0.843, while the A UC of GRACE risk score combined with RDW was 0.925. Conclusion RDW level and GRACE risk score has a similar predictive value to 30 d CVD mortality, GRACE risk score combined with RDW can improve the predictive value of 30 d CVD mortality in patients with ACS.