摘要
目的：研究HEART风险评分在非急性心肌梗死性胸痛人群的应用价值。方法：这是一个源于前瞻性获得的数据库的回顾性研究。连续入选2014年9月至2015年2月,在北京安贞医院急诊胸痛中心就诊的胸痛患者。计算HEART评分。研究终点为3个月时主要不良心脏事件。结果：研究总计入选1041名胸痛患者。其中,332名患者发生了主要不良心脏事件。HEART评分的受试者操作特征曲线下面积为0.77（95%CI：0.74~0.80）。随评分增加,主要不良心脏事件显著增加（P〈0.001）。入选的所有患者分成三组：低危组（评分0~2分）,中危组（评分3~4分）和高危组（评分5~8分）,主要不良心脏事件发生率分别为1.7%,17.1%和54.6%,各组间差异有统计学意义（P〈0.001）。不同的组别,给予不同的分诊方案。结论：HEART风险评分可以用于急诊科非急性心肌梗死性胸痛患者的分诊和预后评估。
Objective： To study HEART risk score in chest pain patients without acute myocardial infarction in the emergency department（ ED）. Methods： This retrospective cohort study used a prospectively acquired database. Chest pain patients without acute myocardial infarction were enrolled in the ED. Data recorded on arrival at the ED were used. The serum sample of high-sensitivity Troponin I was detected. The HEART score was calculated. The end point was major adverse cardiac events（ MACE） within 3 months after presentation. Results： A total of 1041 patients were included. 332 patients（ 319%） underwent a MACE within 3months. MACE increased significantly as the risk score increased（ P 〈0. 001 by chi-square for trend）. The area under the receiver operating characteristic curve was 0. 77（ 95% confidence interval： 0. 74- 0. 80）. In three subgroups,the areas under the receiver operating characteristic curve were also more than 0. 70. Included patients were categorized into three groups： low risk（ score 0- 2）,intermediate risk（ score 3- 4）,and high risk（ score 5- 8）; MACE rates were 1. 7%,17. 1%,and 54. 6%,respectively（ P〈 0. 001）. Different recommendations were given. Conclusions： The HEART risk score may aid triage and prognostic assessment of chest pain patients without acute myocardial infarction in the ED.
出处
《心肺血管病杂志》
2016年第1期25-28,共4页
Journal of Cardiovascular and Pulmonary Diseases
基金
首都临床特色应用研究重点项目(项目编号:Z141107002514014)
