《2021年AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR胸痛评估与诊断指南》解读  

Interpretation of 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain

作　　者：李东泽[1,2] 刘伯夫 周法庭[1,2] 简孟瑶 王智渊 向昕杰[1,2] 唐颂岭 马雯 贾禹 曹钰 LI Dongze;LIU Bofu;ZHOU Fating;JIAN Mengyao;WANG Zhiyuan;XIANG Xinjie;TANG Songling;MA Wen;JIA Yu;CAO Yu(Department of Emergency Medicine/Laboratory of Emergency Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Disaster Medical Center,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院急诊科/急诊医学研究室,成都640041 [2]四川大学灾难医学中心,成都640041

出　　处：《华西医学》2021年第11期1488-1496,共9页West China Medical Journal

基　　金：国家自然科学基金(82072135);四川省科技计划项目(2021YFS0023)。

摘　　要：美国心脏协会等七大协会于2021年10月28日首次联合发布了《2021年AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR胸痛评估与诊断指南》。此次指南强调了急性胸痛风险分层和诊断流程,考虑了低风险胸痛诊断检查的成本经济效益,并建议与患者共享决策。该指南主要涉及胸痛初始评估、以患者为中心的急性胸痛诊治流程和稳定型胸痛患者的评估。该文通过文献查阅,对指南推荐要点进行详细解读。The American Heart Association and other six major associations jointly released AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain for the first report on October28 th, 2021. This guideline stresses the risk stratification and the diagnostic workup of acute chest pain, considers the costeffectiveness of low-risk chest pain diagnosis and examination, and recommends sharing decisions with patients. This guideline mainly involves the initial evaluation of chest pain, choosing the right pathway with patient-centric algorithms for acute chest pain, and the evaluation of patients with stable chest pain. This review makes a detailed interpretation of the recommended points of the guideline through reviewing the literature.

关 键 词：胸痛 心绞痛 冠心病 急性冠脉综合征 临床决策路径 

分 类 号：R541.4[医药卫生—心血管疾病]