HEART评分在急性非高危心源性胸痛患者病情评估和药物治疗中的应用  

Application analysis of HEART score in the evaluation of acute non-high-risk cardiogenic chest pain pa-tients and drug treatment

作　　者：李筱姝 李志民 李志强[1] Li Xiaoshu;Li Zhimin;Li Zhiqiang(Department of Emergency,Mentougou Teaching Hospital,Capital Medical University,Beijing 102300,China)

机构地区：[1]首都医科大学门头沟教学医院急诊科,北京102300

出　　处：《中国药物与临床》2023年第6期371-375,共5页Chinese Remedies & Clinics

摘　　要：目的分析HEART评分在急性非高危心源性胸痛患者评估中的应用效果并指导药物治疗。方法选取2020年1月至12月就诊于首都医科大学附属门头沟教学医院急诊科的急性非高危心源性胸痛患者为对照组,2021年1月至12月就诊的急性非高危心源性胸痛患者为观察组,依据HEART评分进行危险分层,比较2组患者急性冠状动脉综合征(ACS)诊断的差异及心脏不良事件(MACE)发生的差异。结果观察组患者117例,中危患者35例(占35.0%),诊断ACS 18例(占36.6%),低危患者43例(占36.8%),诊断ACS 1例(占2.3%),与对照组比较差异有统计学意义(P<0.05)。观察组患者的发生MACE 9例(占7.7%),低于对照组,2组差异有统计学意义[OR(95%CI)=0.43(0.19,1.00),P<0.05]。控制混杂因素后发现使用HEART评分进行病情分级对患者30 d MACE的影响差异有统计学意义[OR(95%CI)=0.40(0.17,0.96),P<0.05]。结论HEART评分可以准确筛选出急性非高危心源性胸痛的中、低危ACS患者,保障患者安全,可以用作急性非高危心源性胸痛患者快速病情评估和用药指导的工具。Objective To explore the effects of HEART score in the evaluation of patients with acute non-high-risk cardiogenic chest pain.Methods The patients with acute non-high-risk cardiogenic chest pain who visited the emergency department of Mentougou Teaching Hospital,Capital Medical University from January to December 2020 were selected as the control group,and the patients with acute non-high-risk cardio-genic chest pain who presented from January to December 2021 were the observation group,whose risk stratification was based on the HEART score.The differences in the diagnosis of acute coronary syndrome and the difference in ad-verse events between the two groups were compared.Results There were 117 patients in the observation group,35 intermediate-risk patients(35%),18 cases(36.6%)were diagnosed with ACS,43 cases(36.8%)were diagnosed with low-risk patients,and 1 case(2.3%)was diagnosed with ACS.The difference was statistically significant com-pared with the control group(P<0.05).Major adverse cardiac events(MACE)occurred in 9 patients(7.7%)in the observation group,which was lower than that in the control group,and the difference between the two groups was statistically significant[OR(95%CI):0.43(0.19,1.00),P<0.05].After controlling for confounders,it was found that the effect of using HEART score for disease grading on the patient′s 30 days MACE was statistically significant[OR(95%CI):0.40(0.17,0.96),P<0.05].Conclusion HEART score can accurately screen middle and low-risk ACS patients with acute non-high-risk cardiogenic chest pain,ensure patient safety,and can be used as a tool for rapid assess-ment and management of patients with acute non-high-risk cardiogenic chest pain.

关 键 词：心脏病 HEART评分 急性非高危心源性胸痛 病人病情 药物治疗 

分 类 号：R541.4[医药卫生—心血管疾病]