肌钙蛋白即时检验在急性冠状动脉综合征疑似患者院前急救中的应用  

Application of cTnI POCT in pre-hospital first aid of patients with symptoms suggestive of acute coronary syndrome

作　　者：陶金喆[1] 张晨[2] 骆睿翔 TAO Jinzhe;ZHANG Chen;LUO Ruixiang(Beijing Emergency Medical Center,Beijing 100031,China)

机构地区：[1]北京急救中心,北京100031 [2]北京中医药大学,北京100029

出　　处：《中国急救复苏与灾害医学杂志》2024年第3期309-312,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：北京急救中心“135”科研培育计划(编号:YN2019-06)。

摘　　要：目的探讨疑似急性冠状动脉综合征(ACS)在院前急救车上应用即时检验(POCT)检测肌钙蛋白Ⅰ(cTnⅠ)的优势及可行性分析。方法将2019年5月—2020年5月北京急救中心院前接诊的60例疑似急性冠状动脉综合征(ACS)患者,通过现场抽签的方式随机分为试验组30例和对照组30例,对照组常规收集患者病史资料、进行体格检查和心电图测量,试验组在对照组基础上增加POCT检测cTnⅠ,比较两组患者急诊停留时间(EDLOS)、从首次医疗救治(FMC)到接受血运重建时间、出院45 d不良心血管事件发生率。结果试验组EDLOS较对照组更短(P<0.05),试验组从FMC到接受血运重建时间较对照组更短(P<0.05),试验组出院45 d不良心血管事件发生率较对照组更低(P<0.05)。结论院前应用POCT检测cTnⅠ能够缩短疑似ACS患者的EDLOS、缩短从FMC到接受血运重建时间、降低出院45 d不良心血管事件的发生率,对院前疑似ACS患者的早期诊断及预后具有一定的临床参考价值。Objective To study the advantages and feasibility analysis of using point-of-care testing(POCT)to detect cardiac troponin I(cTnI)of patients withsymptoms suggestive of acute coronary syndrome(ACS)in ambulance.Methods Sixty patients with symptoms suggestive of ACS who were admitted to the Beijing Emergency Center from May 2019 to May 2020 were randomly divided into test group and control group by spot drawing.The control group routinely collected patient medical history data,routine physical examination,and electrocardiogram.The test group added POCT to detect cTnI.Emergency department length of stay(EDLOS);first medical care(FMC)to revascularization;and the incidence of major cardiovascular events 45 days after discharge were compared between the two groups.Results There were significant differences between two groups in EDLOS,the time from FMC to revascularization and the incidence of major cardiovascular events45 days after discharge(P<0.05).Conclusion Pre hospital cTnI POCT can shorten EDLOS and the time from FMC to revascularization;reduce the incidence of major cardiovascular events in patients with symptoms suggestive of acute coronary syndrome.

关 键 词：即时检验 院前急救 急性冠状动脉综合征 肌钙蛋白Ⅰ 随机对照 

分 类 号：R196.7[医药卫生—卫生事业管理]