急性冠脉综合征并发糖尿病患者GRACE评分的临床意义

目的:评价全球急性冠状动脉事件注册（GRACE）评分对急性冠脉综合征(ACS)患者冠状动脉病变及预后的预测价值。方法: 收集2007年1月~2009年12月在我院住院的ACS患者212例，行GRACE危险评分并行冠状动脉造影，分析不同组别的冠状动脉造影特点、糖尿病与GRACE评分的关系以及6个月终点事件的发生率。结果: 低、中、高危3组患者冠状动脉病变血管支数和病变严重程度的GRACE评分差异具有统计学意义（P<005或P<001）。糖尿病组和非糖尿病组的GRACE评分差异有统计学意义（P<005）。GRACE评分低、中、高危3组终点事件发生率依次有所增高，但差异未达到显著水平。糖尿病组与非糖尿病组的终点事件发生率差异无统计学意义。结论: GRACE评分对冠状动脉病变判定有一定价值，糖尿病患者GRACE评分高危组占较大比例。

GRACE scores and prognosis in patients with acute coronary syndrome complicated by diabetes

AIM:To evaluate value of the Global Registry of Acute Coronary Events (GRACE) scores for acute coronary syndrome (ACS) and prognostic prediction. METHODS: GRACE risk scores were graded and coronary artery angiography was performed in 212 hospitalized patients at our department between January 2007 and December 2009. Angiographic characteristics, the relationship between diabetes and GRACE scores and the incidence rate of 6 month end event in different groups were analyzed. RESULTS: Significant differences of GRACE scores were observed in the number of pathological coronary arteries and the severity of lesions (P<005, P<001). No significant differences were observed in the incidence rate of 6 month end event among the low , medium and high risk groups. No significant differences were seen in the incidence rate of 6 month end event between the groups with diabetes and without diabetes. CONCLUSION: GRACE scoring system has some predictive value with regard to the severity of lesions and the prognostic assessment of patients with coronary artery disease. High risk group accounts for a large proportion in patients with diabetes.