血清肌酐和肌酐清除率对急性ST段抬高型心肌梗死患者短期死亡风险的预测价值Predictive value of serum creatinine and creatinine clearance rate on short-term risk of death in patients with acute ST--eleva-tion myocardial infarction
孙建平;王文玲;
摘要(Abstract):
目的探讨血清肌酐(serum creatinine,Scr)水平和肌酐清除率(creatinine clearance rate,Ccr)对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者死亡风险的预测价值。方法选取2016年7月至2017年7月本院接诊的145例急性STEMI患者为研究对象。记录所有患者的临床资料、Scr水平及Ccr,根据预后情况将研究对象分为生存组(120例)和死亡组(25例),比较两组的一般资料,应用ROC曲线分析Scr水平和Ccr的最佳截断点并判断其对STEMI患者死亡的预测价值。结果 Scr水平> 114.90μmol/L时预测患者死亡的灵敏度为0.84,特异度为0.75,AUC为0.785(95%CI:0.705~0.866);Ccr水平<70.50 ml/min时预测患者死亡的灵敏度为0.76,特异度为0.73,AUC为0.799(95%CI:0.704~0.893)。Scr水平升高、Ccr降低是急性STEMI患者30天内死亡的危险因素(P <0.05)。在校正了年龄、脑卒中、Killip分级等因素后,Scr升高、Ccr降低仍是急性STEMI患者30天内死亡的独立预测因子(P <0.05)。结论急性STEMI患者入院时Scr> 114.90μmol/L和Ccr <70.50 ml/min,对其30天内死亡具有较好的预测价值;高Scr水平和低Ccr是急性STEMI患者死亡的独立预测因子。
关键词(KeyWords): 急性ST段抬高型心肌梗死;血清肌酐;肌酐清除率
基金项目(Foundation):
作者(Authors): 孙建平;王文玲;
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