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  

The value of HEART risk score in predicting 30-day major adverse cardiovascular events of acute chest pain patients presented to emergency department

作　　者：黄振华[1] 詹红[1] 肖孝勇 叶子[1] 蒋鹏[1] 蔡锐彬[1] 廖瑾莉[1] HUANG Zhenhua;ZHAN Hong;XIAO Xiao;YE Zi;JIANG Peng;CAI Ruibin;Liao Jinli(Department of Emergency,The First Affiliated Hospital of Sun Sat.sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院急诊科,广州市510080

出　　处：《实用医学杂志》2017年第14期2341-2344,共4页The Journal of Practical Medicine

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(P<0.05);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(P<0.05);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。Objective To explore the HEART risk score in predicting30?day major adverse cardiovascular events(MACE)for the patients presenting to Emergency Department(ED)with acute chest pain.Methods Patients presented in our ED with acute chest pain were enrolled from January,2016to April,2016.All cause MACE of each patient were followed up at30days by Health insurance information management System and call.Results Total209patients were enrolled(mean age65.28±16.85years;52.63%male).The age,hypertension,ratio of ACS,SpO2,in?patient number HEART score in MACE subject were significantly higher than that in non MACE patients(P<0.05).The blood pressure at admission of MACE patients was significantly decrease than thatin non MACE patients(P<0.05).The MACE within30days was5.74%.The respective areas under the curve(AUC)for30?day MACE(95%CI)was0.908(0.846~0.974).The percent of patients with30?day MACE with HEART scores between0%and3,4~6,and7~10was0%,2.5%,and27%,respectively.Conclusion HEART score can be simple,rapid and accurate prediction of emergency department of patients with acute chest pain within30days of MACE,effective elimination of low?risk patients with MACE,it plays a very important role for disease assessment and diagnosis and treatment process in emergency department.

关 键 词：HEART评分 急性胸痛 急诊科 心血管不良事件 

分 类 号：R459.7[医药卫生—急诊医学]