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目的 评价不同冠心病危险评分方法对急性冠脉综合征（ACS）患者多支病变经皮冠状动脉介入（PCI）治疗术后长期预后评价能力。方法 连续入选住院ACS并行PCI患者192例，收集临床资料包括性别、年龄、临床诊断、心脏及周围血管超声、血脂、肾功能等临床资料，进行SYNTAX、SYNTAX II、临床SYNTAX、EuroScoreII评分、ESRS危险分层，同时进行2年临床随访，随访主要不良心脑血管事件（MACCE,包括全因死亡、卒中、冠脉血运重建、心力衰竭、心绞痛住院治疗）。结果 发生MACCE 24例，其中心源性死亡5例，卒中死亡2例，血运重建7例，缺血性卒中6例，心衰4例。MACCE组和无事件组的SYNTAX评分、SYNTAX II评分、临床SYNTAX 和EuroScoreII评分分别为(18±6)与(15±7)分（P<0.05）、(29±5)与(27±8)分(P<0.05)、(41±16)与(36±22)分（P<0.05）、(4.0±3.6)与(2.7±2.1)分（P<0.05）。ESRS高危、低危组事件发生率分别为29%和21%，与无事件组比较，P<0.05。SYNTAX评分、SYNTAX II评分、临床SYNTAX评分、EuroScoreII评分和ESRS预测2年终点事件的曲线下面积分别为0.631、0.631、0.630、0.634和0.656（均P<0.05）。5种评分方法危险分层均与2年MACCE相关。结论 SYNTAX评分、SYNTAX II评分、临床SYNTAX评分、EuroScore2以及ESRS危险分层对ACS行PCI后MACCE的预测能力无显著差异。
Objective To evaluate the long-term prognostic ability of different coronary heart disease risk score in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 192 hospitalized patients with ACS were enrolled in this study. Clinical data including gender, age, clinical diagnosis, heart and peripheral blood vessels, blood lipids and renal function were collected for SYNTAX, SYNTAX II, clinical SYNTAX, EuroScoreII score and ESRS risk Stratified, followed by 2 years of clinical follow-up, follow-up of major adverse cardiac and cardiovascular events (MACCE, including all-cause death, stroke, coronary revascularization, heart failure, angina pectoris hospitalization). Results MACCE occurred in 24 cases, including 5 cases of cardiac death, 2 died of stroke, revascularization in 7 cases, ischemic stroke in 6 cases, 4 cases of heart failure. SYNTAX score, SYNTAX II score, clinical SYNTAX score and EuroScoreII score in MACCE group and non-event group were (18 ± 6) and (15 ± 7) points (P <0.05), (29 ± 5) and (27 ± 8) (P <0.05), (41 ± 16) and (36 ± 22) points (P <0.05), (4.0 ± 3.6) and (2.7 ± 2.1) points respectively. The incidence of ESRS high-risk, low-risk group events was 29% and 21%, respectively, P <0.05 compared with the no-event group. The area under the curve of the SYNTAX score, the SYNTAX II score, the clinical SYNTAX score, the EuroScoreII score and the ESRS predicted the 2-year end point events were 0.631, 0.631, 0.630, 0.634 and 0.656, respectively (P & lt; 0.05). Five scoring methods risk stratification were associated with 2-year MACCE. Conclusions SYNTAX score, SYNTAX II score, clinical SYNTAX score, EuroScore2 and ESRS risk stratification had no significant difference in predicting MACCE of ACS after PCI.