HEART风险评分在有冠心病的急性胸痛人群中的应用研究  

HEART risk score in chest pain patients with coronary heart disease in emergency department

作　　者：马春朋[1] 刘晓丽[2] 蔡丽丽[1] 朱爱红[1] 董雪飞[1] 马春明[2] 马利祥[1] 王庆胜[1] 聂绍平[3] MA Chun-peng;LIU Xiaoli;CAI Lili;ZHU Aihong;DONG Xuefei;MA Chunming;MA Lixiang;WANG Qingsheng;NIE Shaoping(The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院心内科,河北秦皇岛066000 [2]秦皇岛市第一医院内分泌科,河北秦皇岛066000 [3]首都医科大学附属北京安贞医院急诊危重症中心,北京100029

出　　处：《实用医学杂志》2021年第2期215-219,共5页The Journal of Practical Medicine

基　　金：河北省卫生健康委员会医学科学课题研究计划(编号:20201318)。

摘　　要：目的研究HEART风险评分在有冠心病的急性胸痛人群中的应用价值。方法利用已有数据库进行回顾性分析。连续入选有冠心病病史的急性胸痛人群,计算HEART风险评分。研究终点为3个月时主要不良心脏事件。结果研究共入选377例急性胸痛患者,其中186例患者发生主要不良心脏事件。HEART风险评分的受试者操作特征曲线(ROC)下面积为0.73(95%CI:0.68~0.78)。入选患者分为3组:低危组(评分2~3分),中危组(评分4~5分)和高危组(评分6~10分),主要不良心脏事件发生率分别为8.3%(1/12),38.3%(72/188)和63.8%(113/177),各组间差异有统计学意义(P<0.001)。根据不同的危险分层,实施不同的分诊策略。结论HEART风险评分可以用于有冠心病的急性胸痛人群的分诊。Objective To study HEART risk score in chest pain patients with coronary heart disease(CHD)in the emergency department(ED).Methods This retrospective cohort study used a prospectively acquired database.Chest pain patients admitted to the emergency department of Beijing Anzhen Hospital from September 2014 to July 2015 were enrolled.Baseline characteristics of patients were included.The endpoint(major adverse cardiovascular events,MACE)was a composite of acute myocardial infarction,percutaneous coronary interven⁃tion,coronary artery bypass graft,and all⁃cause death within 3 months after initial presentation.Results The study enrolled 377 eligible patients,and 186 patients(49.3%)had a MACE within 3 months.A significant pro⁃gressive pattern of increasing MACE rate was observed as the score increased(P<0.001 by chi⁃square for trend).The area under the receiver operating characteristic(ROC)curve was 0.73[95%CI:0.68~0.78]in all chest pain patients.Patients were categorized into three groups:low risk(score 2~3),intermediate risk(score 4~5),and high risk(score 6~10);MACE rates were 8.3%(1/12),38.3%(72/188)and 83.8%(113/177),respectively(P<0.001).Recommendations for patient triage were different.Conclusions The HEART risk score was validat⁃ed in chest pain patients with CHD and may aid patients triage in the ED.

关 键 词：胸痛 急诊 冠心病 风险评分 高敏肌钙蛋白I 

分 类 号：R541.4[医药卫生—心血管疾病]