中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2015年
7期
725-728
,共4页
心脏评分%胸痛%急性冠脉综合征%危险分层
心髒評分%胸痛%急性冠脈綜閤徵%危險分層
심장평분%흉통%급성관맥종합정%위험분층
HEART score%Chest pain%Acute coronary syndrome%Risk stratification
目的 应用心脏评分(HEART)评价急诊胸痛患者中发生急性冠脉综合征的危险程度并判断其预后,以证明其应用的有效性.方法 连续观察急诊胸痛患者1 200例,分别计算各自HEART评分并进行长期随访,Kaplan-Meier法用以计算生存率,ROC曲线下面积观察该方法的准确性,并与TIMI和GRACE评分进行比较.结果 34.5％的患者为低分组(HEART评分0～3),MACE事件发生率为1.4％;50.7％为中分组(4～6),MACE事件发生率为22.2％;14.8％为高分组(7～10),MACE事件发生率为60.7％;3组比较差异具有统计学意义(Log-rank,P＜0.01);心脏评分ROC曲线分析结果显示,曲线下面积(AUC) =0.83[95％ CI:0.80 ～0.85,P＜0.01],显著高于GRACE评分(0.76)和TIMI评分(0.72).结论 HEART评分适用于急诊胸痛患者发生急性冠脉综合征的风险预测和预后判断.
目的 應用心髒評分(HEART)評價急診胸痛患者中髮生急性冠脈綜閤徵的危險程度併判斷其預後,以證明其應用的有效性.方法 連續觀察急診胸痛患者1 200例,分彆計算各自HEART評分併進行長期隨訪,Kaplan-Meier法用以計算生存率,ROC麯線下麵積觀察該方法的準確性,併與TIMI和GRACE評分進行比較.結果 34.5％的患者為低分組(HEART評分0～3),MACE事件髮生率為1.4％;50.7％為中分組(4～6),MACE事件髮生率為22.2％;14.8％為高分組(7～10),MACE事件髮生率為60.7％;3組比較差異具有統計學意義(Log-rank,P＜0.01);心髒評分ROC麯線分析結果顯示,麯線下麵積(AUC) =0.83[95％ CI:0.80 ～0.85,P＜0.01],顯著高于GRACE評分(0.76)和TIMI評分(0.72).結論 HEART評分適用于急診胸痛患者髮生急性冠脈綜閤徵的風險預測和預後判斷.
목적 응용심장평분(HEART)평개급진흉통환자중발생급성관맥종합정적위험정도병판단기예후,이증명기응용적유효성.방법 련속관찰급진흉통환자1 200례,분별계산각자HEART평분병진행장기수방,Kaplan-Meier법용이계산생존솔,ROC곡선하면적관찰해방법적준학성,병여TIMI화GRACE평분진행비교.결과 34.5％적환자위저분조(HEART평분0～3),MACE사건발생솔위1.4％;50.7％위중분조(4～6),MACE사건발생솔위22.2％;14.8％위고분조(7～10),MACE사건발생솔위60.7％;3조비교차이구유통계학의의(Log-rank,P＜0.01);심장평분ROC곡선분석결과현시,곡선하면적(AUC) =0.83[95％ CI:0.80 ～0.85,P＜0.01],현저고우GRACE평분(0.76)화TIMI평분(0.72).결론 HEART평분괄용우급진흉통환자발생급성관맥종합정적풍험예측화예후판단.
Objective To study the value of HEART scores in predicting the risk of getting acute coronary syndrome in patients with chest pain and assessing the prognosis in order to elucidate the validity of the HEART scores.Methods A total of 1 200 patients with chest pain were continuously observed and followed up,and their HEART scores were calculated.The survival rates were calculated with Kaplan-Meier method and AUROC (area under ROC curve) was used to determine the accuracy of this methods.The HEART scores were compared with TIMI and GRACE scores.Results Low HEART scores (0-3) were found in 34.5％ of the patients and MACE (major adverse cardiac event) occurred in 1.4％ of them.The patients with intermediate HEART scores (4-6) accounted for 50.7％ patients,and MACE was diagnosed in 22.2％ of them.High HEART scores (7-10) were found in 14.85％ patients,and MACE occurred in 60.7％ of them.There was significant difference among these three groups (Log rank P ＜ 0.01).The AUROC of HEART score was 0.83 (95％ CI:0.80-0.85,P ＜0.01),being significantly higher than the GRACE scores (0.76) and TIMI scores (0.72).Conclusions The HEART score is applicable for predicting the risk of getting acute coronary syndrome of chest pain patients in emergency department and the prognosis.
