Non-st-segment Elevation Acute Myocardial Infarction Grace Score And Blood Stasis Syndrome

Background:Acute myocardial infarction, which is called "chestightness", "genuin heart hurt" in traditional chinese medicine, is a common heart disease with higher morbidity and mortality in the old people.Clinically, the symptoms are characterized as chest stuffy pain or tingling, palpitations, shortness of breath. According to electrocardiogram of st-segment elevation patterns, acute myocardial infarction (AMI) can be divided into st-segment elevation acute myocardial infarction (STEMI) and the non-ST segment elevations acute myocardial infarction (NSTEMI). The etiology and pathogenesis of NSTEMI is very complex, its pathological mechanism is not entirely clear. Generally, acute coronary syndrome (ACS) symptoms, including unstable angina and non st-elevation myocardial infarction, resulted from acute coronary vulnerability, refering to those plaques, unstable and thrombosis tendency patches. ACS is on account of plaques rupture and erosion,concurrent thrombosis, vasospasm and microvascular embolism under the action of many factors such as as a result of acute or subacute myocardial oxygen decrease.In recent years the diagnosis and treatment of STEMI has common consensus that, early thrombolysis or percutaneous coronary intervention (PCI) reascularization can effectively improve the prognosis.But for NSTEMI patients, its risk stratification, interventional strategies and prognosis still exist various controversy. To strengthen NSTEACS patients early risk stratification, take timely and effective intervention strategies to reduce cardiovascular adverse events, and improve the prognosis of patients is with clinical significant importance.Nowadays, the widely accepted risk stratification method is GRACE risk score. TCM symptom scores mainly adopted blood stasis score, revised at the 2nd national conference for activating blood circulation and eliminating stasis standard. in 1986.Appropriate risk stratification of accurate and fast for the selection and treatment strategies for long-term outcome is very important.Objective:Investigate the correlation of different risk stratification and blood stasis score; Different risk stratification analysis of the prognosis. TCM blood stasis trying to prove the score to the correlation of the risk stratification and prognosis, enhance clinical applicability. Expect Chinese blood stasis NSTACS integral for the risk of patients with a stronger guidance to distinguish with convenient clinical application choose appropriate treatment strategies.Method:From January 2006 to 2010 August in Chinese medicine academy of sciences the xiyuan hospital treatment with non-st-elevation myocardial infarction of the general situation, hospital clinical data. According to GRACE for risk stratification and get their score points blood stasis. According to different risk stratification analysis its and blood stasis integral relevance.Observe different in different periods of the risk stratification of destination event rates; Different blood stasis score level of different period ending the event rate; Compare the risk stratification of blood stasis and different points of different its prognosis is different.Result:GRACE risk stratification three groups of patients admission biochemical supreme muscle calcium protein T, urea nitrogen, serum creatinine, HDL, BUN have significant differences.GRACE score and the blood stasis score two variables line linear regression analysis, this paper concludes that GRACE score (X) and blood stasis score (Y) for: the relationship between 147.501+0.431 X Y=(P=0.00).Diabetes and hypertension exist all can make GRACE score and the blood stasis score to rise, but two factors affecting each other. Double variable correlation analysis GRACE score and blood stasis score Pearson correlation coefficient is 0.431, P=0.000, for moderate related.And from a year mean trend diagram and whether the simple survival scatterplot chart can be seen GRACE score and blood stasis, and the integral points related, the higher the worse prognosis. Independent sample t-test illustrate:admission GRACE score and the blood stasis score for hospitalization, discharged patients, and discharge 30 days after 3 months and 6 months after discharge and 1 year after discharge end is occurring, are obviously impact events.Survival analysis method of Meier Kaplan-Rank (Mantel-Log Cox) inspection P=0.047, P<0.05 differences are statistically significant. So, we think the different GRACE to the risk stratification of survival curves that affect different, high-risk group in survival rates lower survival rates low. The dangerous crowd COX regression model showed that the survival curve has affect is the GRACE score 0.041, whether the law, P=medicine P=0.000 and history of diabetes and hypertension, P=0.039 history P=0.031.