胸痛患者各器官功能指标实验室检测结果及临床诊疗分析

Analysis of laboratory test results and clinical diagnosis and treatment of organ function indexes in patients with chest pain

目的 分析胸痛患者各器官功能指标实验室检查结果,为其早期识别和干预提供理论依据。方法 收集138例急性高危胸痛患者临床资料,回顾性统计分析患者的症状体征、实验室检查等相关危险因素。结果 138例高危胸痛患者hs-Tn I、CK、LDH、AST、血Na+、ALT、D-D二聚体、Pa CO2、AB初始值异常率均> 70%。随着时间推移和病程进展,血清CK、hs-Tn I有升高趋势。高危胸痛病因中,心源性胸痛为主要病因占77. 5%,明显高于肺栓塞、主动脉夹层源性胸痛(P <0. 05);其中男性发病率高于女性(P <0. 05),发病呈年轻化趋势,多伴高血压(60. 9%)和吸烟(51. 4%)。结论 急性胸痛是急诊科常见症状且病因复杂,其中高危胸痛危害甚大,以ACS最多见;累及多个器官和系统,并发症多,CK、hs-Tn I升高对判断病情变化有一定帮助。

Objective To analyze the laboratory examination results of organ function indexes of patients with chest pain,so as to provide theoretical basis for the early recognition and intervention.Methods The clinical data of 138 patients with acute high-risk chest pain were collected.The symptoms,signs,auxiliary examination,diagnosis,prognosis and related risk factors of these patients were retrospectively analyzed.Results The abnormal rate of hs-Tnl,CK,LDH,AST,blood Na+,ALT,D-D dimer,PaCO2,AB initial value in 138 patients with high—risk chest pain were more than 70%.Serum CK and hs-Tnl tended to increase with the course of disease.The main cause of chest pain was chest pain,which accounted for 77.5%,and significantly higher than that of pulmonary embolism and aortic dissection induced chest pain(P<0.05).The incidence rate of male patients was higher than that of females(P<0.05),and the incidence of them was younger,maily with hypertension(60.9%)and smoking(51.4%).Conclusion Acute chest pain is a common symptom in emergency department and its etiology is complex.Among them,high-risk chest pain is very harmful,especially ACS.The increase of CK and hs-Tnl is helpful to judge the change of disease.