HEART评分对急诊科急性胸痛患者30天心血管不良事件预测价值

发布时间：2018-01-10 02:29

本文关键词：HEART评分对急诊科急性胸痛患者30天心血管不良事件预测价值　出处：《实用医学杂志》2017年14期 　论文类型：期刊论文

【摘要】：目的评价HEART评分对急性胸痛患者30 d心血管不良事件(MACE)的预测价值。方法使用前瞻性观察研究的方法,收集2016年1-4月在我院急诊科就诊的急性胸痛患者,并对纳入的患者进行30 d心血管不良事件的随访。结果本研究纳入209例患者,平均(65.28±16.85)岁,男110例(52.63%),MACE组患者年龄、高血压、ACS比率、SpO_2、需要住院、HEART评分高于非MACE组,2组比较差异具有统计学意义(P0.05);MACE组患者入院血压(收缩压、舒张压)低于非MACE组,2组比较差异具有统计学意义(P0.05);30 d随访发生心血管不良事件概率为5.74%,HEART评分对30 d心血管不良事件的发生有良好的预测价值,ROC曲线下面积为0.908(95%CI 0.846~0.974),不同HEART评分危险分层30 d心血管不良事件概率分别为0~3分(0)、4~6分(2.5%)、7~10分(27%)。结论 HEART评分能简单、快速、准确的预测急性胸痛患者30 d内MACE,有效排除低危胸痛患者MACE,对急诊科快速病情评估和诊治过程起到非常重要的作用。
[Abstract]:Objective to evaluate the value of HEART score in predicting adverse cardiovascular events in patients with acute chest pain at 30 days. Patients with acute chest pain in our emergency department from 2016 to April were collected and followed up for 30 days with cardiovascular adverse events. Results 209 patients were included in this study. The mean age was 65.28 卤16.85 years old. 110 male patients (52.63%) were diagnosed as Mace patients. The ACS ratio of hypertension and ACS was higher than SPO _ 2. The patients needed to be hospitalized. The HEART score was significantly higher than that in non-#en1# group (P 0.05). The blood pressure (systolic blood pressure, diastolic pressure) in MACE group was lower than that in non-#en1# group (P 0.05). The probability of adverse cardiovascular events in 30 days follow-up was 5.74% and head score had a good predictive value for the occurrence of adverse cardiovascular events at 30 days. The area under the ROC curve was 0.908 / 95 / CI 0.846 / 0.974). The odds of cardiovascular adverse events in different HEART risk stratification were 0 ~ 3, 0 ~ 4 ~ 6 and 2.5). Conclusion HEART score is simple, rapid and accurate in predicting MACE in patients with acute chest pain within 30 days, and can effectively exclude MACE in patients with low risk chest pain. It plays a very important role in the rapid assessment and diagnosis of the emergency department.
【作者单位】：中山大学附属第一医院急诊科;
【分类号】：R459.7
【正文快照】： 急性胸痛是急诊科最常见症状之一[1],占急诊内科患者的5%~20%,在大型三甲医院甚至占20%~30%[2]。急性胸痛病因复杂,危险系数高,接近15%是急性心肌梗死,30%~35%是不稳定性心绞痛,而在急诊科通过连续心电图(ECG)和心肌损害标记物检查排除急性冠脉综合征(acutecoronary syndrome,

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