急诊科胸痛的调查研究

The Survey for Patients Presented to Emergency Room with Chest Pain

目的探索急诊科胸痛患者的病因学构成，分析高敏C反应蛋白（hypersensitiveC-reactiveprotein，hs-CRP）对胸痛的诊断价值，规范诊治流程，以期提高对胸痛的早期诊断率。方法选择2015年5月1日-2016年1月30日因胸痛及胸痛等同症状至中山市人民医院急诊科就诊的患者，使用统一表格记录患者的一般资料，就诊方式，既往病史，发病时间，到达医院急诊时间，心电图、心肌生化标志物等辅助检查，初步诊断，急诊的诊治情况，确定诊断和去向及就诊30d的临床转归情况，所有数据经SPSS16．0统计软件进行统计学处理。结果急诊胸痛的病因构成复杂，本研究的急诊胸痛患者中，病因为心源性者485例，占比63．65％，非心源性277例，占比36．35％；在年龄结构上，非心源性胸痛组〉45岁比例高，〉60岁比例低，两组平均年龄、性别、心血管易患因素差异均有统计学意义（P〈0．05）；组间hs-CRP比较发现心源性胸痛组（7．14±18．04）高与非心源性胸痛组（4．50±12．72），组间比较差异有统计学意义（P〈0．05）。结论处置急诊胸痛患者应按流程快速筛选急危重症，并予以及时、有效处理。hs-CRP可以辅助急性胸痛患者心源性疾病的诊断。

Objectives To identify the main etiologies of Emergency Room（ER） patients with chest pain or equivalent syndrome, to analyze the diagnostic values of hypersensitive C-reactive protein （hs-CRP） and to set up standard diagnostic procedures, in order to improve the early diagnosis rate of chest pain. Methods Select ER patients with chest pain or equivalent syndrome in Zhongshan People＇ s Hospital from May 1st, 2015 to January 30th, 2016. A total of 762 patients were enrolled in the study. Among them, 483 are males and 279 are females, which separately accounts for 63% and 36.61% of the total participants. They age from 18 to 92, while the average age of patients was 56.1± 11.12 years. The data （patients＇ general data, medical treatments, anamneses, onset time, the exact time for treatment when arrived, electrocardiograms, accessory examination about cardiac biochemical markers, tentative diagnoses, diagnoses and treatment in the ER, confirmed diagnoses, and 30-day follow-up periods） were collected by unified forms. All the data had been processed by the software SPSS16.0.Results Emergency chest pain causes complex, the study of emergency treatment in patients with chest pain, heart disease because the source of rendering 485 cases, accounted for 63.65%, 277 cases of cardiac, accounted for 36.35%; On age structure, non cardiac chest pain group 〉 45 high proportion, 〉 60 years old low ratio, average age, gender, two groups of cardiovascular susceptible factor differences were statistically significant （P 〈 0.05）; Group of hs - CRP comparison between cardiac chest pain group （7.14 18.04 mm） high and non cardiac chest pain group （4.50-12.72）, and compare the differences between groups was statistically significant （P 〈 0.05）. Conclusion The etiologies of chest pain are complex which means special vigilance is needed for all patients with chest pain. All the patients should be given timely treatments with high efficiency, hs-CRP can indicate cardiogenic disease.