EuroSCORE与SinoSCORE对冠状动脉旁路移植术后患者早期生命质量的预测价值

doi:10.3969/j.issn.1671-167X.2015.05.007

北京大学学报(医学版) ›› 2015, Vol. 47 ›› Issue (5): 769-773. doi: 10.3969/j.issn.1671-167X.2015.05.007

EuroSCORE与SinoSCORE对冠状动脉旁路移植术后患者早期生命质量的预测价值

于婕1，万峰2 ，解基严2，吴松2，崔仲奇2，徐敏2，张喆2△ ，高炜1

（1北京大学第三医院心血管内科，卫生部心血管分子生物学与调节肽重点实验室，北京 100191；2 北京大学第三医院心脏外科，北京 100191)

出版日期:2015-10-18 发布日期:2015-10-18
通讯作者: 张喆 E-mail:zhangzhe@bjmu.edu.cn
基金资助:
海淀区科学技术委员会2010年度基本科技项目（K2008057-Ⅱ）资助

Role of EuroSCORE and SinoSCORE in prediction of early postoperative quality of life in patients after coronary artery bypass surgery

YU Jie1, WAN Feng2, XIE Ji-yan2, WU Song2, CUI Zhong-qi2, XU Min2, ZHANG Zhe2△, GAO Wei1

（1.Department of Cardiology, Peking University Third Hospital;Key Laboratory of Molecular Cardiovascular Sciences Ministry of Education,Beijing 100191, China; 2. Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China)

Online:2015-10-18 Published:2015-10-18
Contact: ZHANG Zhe E-mail:zhangzhe@bjmu.edu.cn
Supported by:
Supported by the Science and Technology Commission of Hai-dian District-Basic Science Support Program of 2010 (K2008057-Ⅱ)

摘要/Abstract

摘要：

目的：探讨欧洲心脏外科手术风险评估系统 (European system for cardiac operative risk evaluation,EuroSCORE) 与中国冠状动脉旁路移植手术评分系统(sino system for coronary operative risk evaluation, SinoSCORE) 对冠状动脉旁路移植术后患者早期生命质量的预测价值。方法：连续选择2010年3月至2013年1月在北京大学第三医院心外科接受冠状动脉旁路移植术的218例患者，术前分别以EuroSCORE和SinoSCORE进行手术风险评价，术前及术后3个月以简明健康调查量表进行生命质量调查，分析不同评分系统对术后早期生命质量的预测价值。校准度采用Hosmer-Lemeshow拟合优度检验评价，分辨力采用ROC曲线下面积(AUC)评价。结果：除疼痛与心理功能两个维度外，患者的手术风险评分与术后早期生命质量存在一定相关性 (r=-0.493～-0.203，P＜0.05)。Logistic回归显示，患者手术风险评分高是术后生命质量低于平均水平的危险因素 (OR＞1.0，P＜0.05)，并且 EuroSCORE的OR值高于SinoSCORE。SinoSCORE模型Hosmer-Lemeshow拟合优度检验P=0.628，AUC=0.754；EuroSCORE模型Hosmer-Lemeshowrny拟合优度检验P=0.538，AUC=0.854。结论：EuroSCORE和SinoSCORE对冠状动脉旁路移植术患者术后早期生命质量的某些方面具有一定的预测价值，并且EuroSCORE的预测价值可能更高。

关键词: 冠状动脉分流术, 治疗结果, 生活质量, 心脏外科手术

Abstract:

Objective：To investigate the predicting value of European system for cardiac operative risk evaluation (EuroSCORE) and sino system for coronary operative risk evaluation (SinoSCORE) in early quality of life of patients after coronary artery bypass surgery (CABG). Methods:A total of 218 consecutive patients who underwent CABG from March 2010 to January 2013 were evaluated with both systems before operation. Health related quality of life (QoL) was estimated by using 36-item short form health survey (SF-36) preoperatively and postoperatively in order to evaluate the predicting value of the two systems in early postoperative QoL. Calibration was evaluated by Hosmer-l,emeshow goodness-of-fit test．Discrimination was tested by determining the area under the receiver operating characteristic (ROC) curve．Results:There was no significant difference between the accumulation of the EuroSCORE and SinoSCORE in the all patients (t=-0.904, P=0.368), When using Wilcoxon test on life quality in the preoperative and postoperative patients respectively,the data showed that the quality of life improved significantly in various dimensions of the postoperative patients (Z=-2.886, P<0.001).Except for bodily pain (BP) and mental health (MH), statistically significant correlation was found between the preoperative risk evaluation scores and the postoperative QoL scores (r:-0.203 to －0.493, P＜0.05). Logistic regression analyses indicated that both the scores emerged as the independent predictor for a relatively worse QoL (OR>1, P＜0.05). Furthermore, the EuroSCORE predicted the outcome with a higher OR. For SinoSCORE the Hosmer-Lemeshow test was significant (P=0.628) and the area under ROC curve was 0.754．For the EuroSCORE the Hosmer-Lemeshow test was significant (P=0.538) and the area under ROC curve was 0.854．Conclusion:Both EuroSCORE and SinoSCORE could be viewed as a predictor for several aspects of postoperative QoL, while EuroSCORE might have a greater predicting value.

Key words: Coronary artery bypass, Treatment outcome, Quality of life, Cardiac surgical procedures

中图分类号:

于婕，万峰,解基严，吴松，崔仲奇，徐敏，张喆,高炜. EuroSCORE与SinoSCORE对冠状动脉旁路移植术后患者早期生命质量的预测价值[J]. 北京大学学报(医学版), 2015, 47(5): 769-773.

YU Jie, WAN Feng, XIE Ji-yan, WU Song, CUI Zhong-qi, XU Min, ZHANG Zhe, GAO Wei. Role of EuroSCORE and SinoSCORE in prediction of early postoperative quality of life in patients after coronary artery bypass surgery[J]. Journal of Peking University(Health Sciences), 2015, 47(5): 769-773.

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EuroSCORE与SinoSCORE对冠状动脉旁路移植术后患者早期生命质量的预测价值

Role of EuroSCORE and SinoSCORE in prediction of early postoperative quality of life in patients after coronary artery bypass surgery

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