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目的探讨以病史、心电图、年龄、危险因素、肌钙蛋白5项指标组成的HEART评分对急诊心源性胸痛的鉴别诊断价值。方法 98例急诊收治的因胸痛前来就诊的患者,均进行HEART评分,根据评分结果分为心源性胸痛组(43例)和非心源性胸痛组(55例),心源性胸痛组再分成心肌梗死组(24例)和心绞痛组(19例)。比较四组患者HEART评分情况。结果心源性胸痛组年龄(67.53±11.72)岁大于非心源性胸痛组(53.64±17.06)岁,危险程度评分(6.41±1.32)分高于非心源性胸痛组(2.35±1.43)分,差异均具有统计学意义(t=4.561、14.422,P<0.01)。心绞痛组年龄(73.24±8.98)岁大于心肌梗死组(62.45±12.47)岁,危险程度评分(5.63±0.86)分低于心肌梗死组(8.22±1.09)分,差异均具有统计学意义(t=3.173、8.472,P<0.01)。结论 HEART评分为临床急诊胸痛患者提供更为简单、快速、可靠的病情与预后评估方法 ,与传统全球急性冠状动脉事件注册评分(GRACE)方法比较,前者更为准确、易于操作,适用于急诊。
Objective To investigate the differential diagnostic value of HEART score composed of 5 items of history, electrocardiogram, age, risk factors and troponin in the diagnosis of acute cardiogenic chest pain. Methods A total of 98 patients with chest pain who were admitted to the hospital for emergency treatment were enrolled in the HEART assessment. According to the results, they were divided into three groups: cardiogenic chest pain group (43 cases) and non-cardiac chest pain group (55 cases) Divided into myocardial infarction group (24 cases) and angina group (19 cases). HEART scores were compared between the four groups. Results The age of the patients with cardiogenic chest pain (67.53 ± 11.72) years was significantly higher than that of non-cardiac chest pain patients (53.64 ± 17.06) years, and the risk score was 6.41 ± 1.32 (2.35 ± 1.43) , The differences were statistically significant (t = 4.561, 14.422, P <0.01). The age of the angina pectoris group (73.24 ± 8.98) was significantly higher than that of the myocardial infarction group (62.45 ± 12.47) years, and the risk score (5.63 ± 0.86) was lower than that of the myocardial infarction group (8.22 ± 1.09), the difference was statistically significant (t = 3.173, 8.472, P <0.01). Conclusion The HEART score provides a simpler, faster and more reliable assessment of the disease and prognosis for patients with clinical emergency chest pain. Compared with the traditional global coronary angiographic registration score (GRACE), the HEART score is more accurate and easy to operate and is suitable for emergency treatment.