评价急诊胸痛评分预测急诊胸痛患者风险的价值

Value of emergency chest pain score in predicting the risk of emergency chest pain

目的评价急诊胸痛评分预测急诊胸痛患者,尤其是急性冠状动脉综合征(acute coronary syndrome,ACS)患者风险的价值。方法根据急诊胸痛评分(Emergency Department Assessment of Chest Pain Score,EDACS)计算出分值,对于<16分者视为低危患者,对于≥16分者视为高危患者。比较心源性胸痛和非心源性胸痛患者、ACS和非ACS患者、急性心肌梗死和不稳定性心绞痛患者的EDACS分值,并分别计算EDACS的敏感度与特异度。结果心源性胸痛患者EDACS分值明显高于非心源性胸痛,ACS患者分值明显高于非ACS患者,急性心肌梗死患者分值与心绞痛患者分值近似。以EDACS≥16分诊断心源性胸痛为标准,EDACS的敏感度为71.77%,特异度为87.62%。以EDACS≥16分诊断ACS为标准,EDACS敏感度为72.92%,特异度为83.98%。以EDACS≥16分诊断急性心肌梗死为标准,EDACS的敏感度为71.02%,特异度为25.31%。结论EDACS能较好地鉴别心源性胸痛患者,尤其是ACS患者,但是不能区分急性心肌梗死和不稳定性心绞痛患者。

Objective To evaluate the value of Emergency Department Assessment of Chest Pain Score(EDACS)in predicting the risk of patients with chest pain,especially with acute coronary syndrome(ACS).Methods The scores were calculated by EDACS,patients with less than 16 scores were regarded as low-risk patients,and patients with more than 16 scores were regarded as high-risk patients.To compare the EDACs of patients with cardiogenic chest pain and non-cardiogenic chest pain,ACS and non ACS,acute myocardial infarction and unstable angina pectoris.The sensitivity and specificity of EDACs were calculated respectively.Results The EDACs of patients with cardiogenic chest pain,especially ACS,was significantly higher.The score of patients with myocardial infarction was similar to that of patients with unstable angina pectoris.If the patient with EDACs≥16 was diagnosed with cardiogenic chest pain,the sensitivity and specificity were 71.77% and 87.62%,respectively.If the patient with EDACs≥16 was diagnosed with ACS,the sensitivity and specificity were 72.92% and 83.98%,respectively.If the patient with EDACs≥16 was diagnosed with acute myocardial infarction,the sensitivity and specificity were 71.02% and 25.31%,respectively.Conclusion Patients with cardiogenic chest pain,especially ACS,can be distinguished by EDACS,but patients with acute myocardial infarction and unstable angina pectoris can not be.