TIMI危险指数对ST段抬高心肌梗死患者预后的预测作用

目的 评价TIMI危险指数对ST段抬高心肌梗死(STEMI)患者30 d、1年死亡率及30 d心力衰竭事件的预测价值.方法 回顾性分析1999年8月至2006年3月间中山大学附属第一医院收冶的229例STEMI患者的临床资料并计算TIMI危险指数:[心率×(年龄/10)2]/收缩压,将TIMI危险指数分成5组(≤2.5,12.5～17.5,17.5～22.5,22.5～30,>30)和看作连续变量分别建立模型,观察两种情况下危险指数对30 d、1年死亡率和30 d心力衰竭发生率的预测情况.结果 STEMI患者的TI-MI危险指数在分成5组和看作连续变量建立模型的两种情况下,30 d、1年死亡率和30 d心力衰竭发生率均随危险指数分值增加而增加,其趋势差异具有统计学意义(P<0.05),预测的ROC曲线下面积分别为0.65、0.68、0.67和0.70、0.72、0.70.结论 TIMI危险指数可以作为一个简单、快速、实用的STEMI患者危险分层的工具.

Effects of TIMI risk index on predicting prognosis m patients with ST-elevation myocardial infarction

Objective To evaluate the value of the TIMI risk index in predicting 30-day and one-yosr mortality and incidence of heart failure in patients with ST-elevation myocardial infarction (STEMI).Method Data of 229 patients with STEM1 from August 1999 to March 2006 in the First Affiliated Hospital,Sun Yat-sen University,were retrospeclively collected,analyzed and scored with TIMI risk index.When categorized into quintiles(≤12.5,12.5～17.5,17.5～22.5,22.5～30,>30) and modeled as a continuous variable,difference of prediction of 30day and one-year mortality and 30-day incidence of heart failure of patients were compared respectively.Results When categorized into quintilos and modeled as a continuous variable,30-day and one-year mortality and 30-day incidence of heart failure were increasing with increasing score of risk index (P<0.05).The area under the recewer operating characteristic curve were 0.65,0.68,0.67 and 0.70,0.72,0.70,respectively.Conclusions The TIM1 risk index can be used as a simple,rapid and practical tool to risk-stratify patients with STEMI.