中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
7期
774-778
,共5页
心肺复苏后%心电图%急性心肌梗死%Meta分析
心肺複囌後%心電圖%急性心肌梗死%Meta分析
심폐복소후%심전도%급성심기경사%Meta분석
Post cardiopulmonary resuscitation%Electrocardiography%Acute myocardial infarction%Meta-analysis
目的 探讨心搏骤停患者复苏后心电图ST段抬高诊断急性心肌梗死(acute myocardial infarction,AMI)的作用.方法 收集1990年1月至2012年10月心肺复苏后自主循环恢复的患者,排除明显心脏外因素后急诊行冠状动脉造影的前瞻性或回顾性病例研究文献,利用Meta-disc1.4软件对所提取的心电图及冠脉造影结果等相关数据进行分析.结果 共纳入5篇文献,包括1017例患者,均为连续性病例回顾研究,Meta分析示心电图ST段抬高诊断AMI的敏感度(SEN) 0.59,特异度(SPE)0.86,阳性似然比(+LR)4.4,阴性似然比(-LR)0.39,诊断比值比(DOR) 12.28,曲线下面积(AUC)0.85.结论 心搏骤停心肺复苏后自主循环恢复患者心电图ST段抬高对于诊断AMI特异性高,但是敏感度低,整体诊断价值不高.
目的 探討心搏驟停患者複囌後心電圖ST段抬高診斷急性心肌梗死(acute myocardial infarction,AMI)的作用.方法 收集1990年1月至2012年10月心肺複囌後自主循環恢複的患者,排除明顯心髒外因素後急診行冠狀動脈造影的前瞻性或迴顧性病例研究文獻,利用Meta-disc1.4軟件對所提取的心電圖及冠脈造影結果等相關數據進行分析.結果 共納入5篇文獻,包括1017例患者,均為連續性病例迴顧研究,Meta分析示心電圖ST段抬高診斷AMI的敏感度(SEN) 0.59,特異度(SPE)0.86,暘性似然比(+LR)4.4,陰性似然比(-LR)0.39,診斷比值比(DOR) 12.28,麯線下麵積(AUC)0.85.結論 心搏驟停心肺複囌後自主循環恢複患者心電圖ST段抬高對于診斷AMI特異性高,但是敏感度低,整體診斷價值不高.
목적 탐토심박취정환자복소후심전도ST단태고진단급성심기경사(acute myocardial infarction,AMI)적작용.방법 수집1990년1월지2012년10월심폐복소후자주순배회복적환자,배제명현심장외인소후급진행관상동맥조영적전첨성혹회고성병례연구문헌,이용Meta-disc1.4연건대소제취적심전도급관맥조영결과등상관수거진행분석.결과 공납입5편문헌,포괄1017례환자,균위련속성병례회고연구,Meta분석시심전도ST단태고진단AMI적민감도(SEN) 0.59,특이도(SPE)0.86,양성사연비(+LR)4.4,음성사연비(-LR)0.39,진단비치비(DOR) 12.28,곡선하면적(AUC)0.85.결론 심박취정심폐복소후자주순배회복환자심전도ST단태고대우진단AMI특이성고,단시민감도저,정체진단개치불고.
Objective To investigate the diagnostic value of ST segment elevation in acute myocardial infarction (AMI) occurred in patients after resuscitation.Methods The relevant articles about coronary angiography performed in an emergency for all the post-resuscitation patients without obvious noncardiac cause,regardless of the representation of the electrocardiography were searched in the databases of Pubmed,Ovid medline,EBSCO,CBM,Wanfang and VIP of Chongqing.The meta-analysis was carried out with the data from the included articles using the meta-disc 1.4 software.Results Five articles about retrospective analysis of consecutive patients were included.The meta-analysis of pooled statistics showed the sensitivity 0.59,the specificity 0.86,the positive likelihood ratio (LR) 4.4,the negative LR 0.39,the diagnostic odds ratio (OR) 12.28 and the area under the curve (AUC) 0.85.Conclusions Although the high specificity is in favor of making diagnosis of AMI in post-resuscitation patients,the low sensitivity makes the integrative diagnostic value of using sole ST-segment elevation of ECG relatively low.
