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目的:比较KAMIR与TIMI危险评分对ST段抬高型心肌梗死(STEMI)患者1年预后的评估价值方法:回顾性分析2010年1-12月广州医科大学第二附属医院收治的111例STEMI患者的临床资料,分析1年死亡率与KAMIR/TIMI危险评分分值的相关性:根据ROC曲线下面积比较KAMIR与TIMI危险评分对患者1年死亡率预测的准确度。结果:出院后1年病死率为19.8%。生存患者与病死患者年龄、高血压史、糖尿病史,就诊时血糖升高等比较,差异有统计学意义(P<0.05)。KAMIR危险评分值与STEMI患者1年死亡率呈正相关性(P<0.05)。KAMIR危险评分对STEMIl年病死率预测的ROC曲线灵敏度为68.1 8%(95%CI 45.1~86.1),特异度为68.54%(95%CI 57.8~78.0)。TIMI危险评分ROC曲线的灵敏度为36.36%(95%CI 17.2~59.3),特异度为79.78%(95%CI 68.7~86.6)。KAMIR危险评分对预测STEMI患者1年病死率的ROC曲线下面积大于TIMI危险评分(AUC 0.728vs.0.614,P=0.036)。结论:KAMIR危险评分比TIMI危险评分对STEMI患者1年病死率预测的准确度更高。
PURPOSE: To compare the diagnostic value of KAMIR and TIMI risk assessment for one-year prognosis of patients with STEMI: a retrospective analysis of 111 STEMI patients admitted to the Second Affiliated Hospital of Guangzhou Medical University from January to December in 2010 The 1-year mortality was analyzed in relation to the KAMIR / TIMI risk score: The accuracy of the 1-year mortality prediction based on KAMIR and TIMI risk scores based on area under the ROC curve. Results: The one-year mortality rate after discharge was 19.8%. There was significant difference between survivors and patients with died of age, history of hypertension, history of diabetes and blood glucose at the time of diagnosis (P <0.05). There was a positive correlation between KAMIR risk score and 1-year mortality in patients with STEMI (P <0.05). The sensitivity of KAMIR risk score to prediction of annual mortality in STEMI was 68.1% (95% CI 45.1-86.1) and 68.54% (95% CI 57.8-78.0). The sensitivity of TIMI risk score ROC curve was 36.36% (95% CI 17.2-59.3) and specificity was 79.78% (95% CI 68.7-86.6). The area under the ROC curve of the KAMIR risk score for predicting the 1-year mortality of patients with STEMI was greater than the TIMI risk score (AUC 0.728 vs. 0.0614, P = 0.036). Conclusions: The KAMIR risk score is more accurate than the TIMI risk score in predicting the 1-year mortality in STEMI patients.