目的 探讨TIMI危险评分在筛选急性心源性胸痛患者中的临床应用价值. 方法 整群选取2013年2月—2014年10月间来该院急诊科或者心内科就诊的急性胸痛患者401例作为研究对象,经病史询查和常规心电图、心肌损伤标志物检测后,根据TIMI危险评分标准对患者进行评分,不同的危险层次给予不同的处理. 对患者进行追踪寻访,了解其就诊近期心血管事件的发生率, 并对不同TIMI评分对急性心源性胸痛的诊断敏感性等进行计算. 结果 根据TIMI危险评分结果,低分组、中分组和高分组的患者分别有263例、105例和33例,各占65.59%、26.18%、8.23%.其主要心血管事件发生率分别为4.94%、47.62%、71.43%,随着TIMI危险评分的增高,患者的主要心血管事件发生率升高,3组患者的比较差异均有统计学意义(P<0.05).经ROC分析,低分组的患者排除急性心源性胸痛的敏感性为95.06%,TIMI危险评分中分组和高分组患者诊断急性心源性胸痛敏感性分别为47.62%和100.00%. 结论 TIMI危险评分用于急性心源性胸痛患者的筛查过程中具有良好的灵敏度,值得临床推广应用.%Objective To investigate clinical value of TIMI risk score in screening patients with acute cardiac chest pain. Methods 401 patients with acute cardiac chest pain who underwent treatment in the Emergency Department or Department of Cardiology in this hospital were selected as the research object. They received medical inquiry, routine ECG examination and detection of car-diac injury markers, and were treated differently according to the risk stratification which came from TIMI risk scoring conducted by us. The patients were followed up to make sure the incidences of cardiovascular events shortly after treatment and sensitivity of TIMI risk score in screening patients with acute cardiac chest pain. Results According to the TIMI risk score, there were 263 pa-tients in the low score group, 105 in the mild score group and 33 in the high score group, accounting for 65.59%, 26.18%, 8.23%respectively, and the incidences of cardiovascular events were 4.94%, 47.62%, 71.43%. The incidences of cardiovascular events were higher in patients with higher TIMI risk score, and there was statistically significant difference between patients with differ-ence risk stratification (P<0.05). It was showed by ROC analysis that the sensitivity of TIMI risk score in screening patients with a-cute cardiac chest pain were 95.06%, 47.62%, 100.00% in the low score group, mild score group, and high score group. Conclu-sion TIMI risk score has high sensitivity in screening patients with acute cardiac chest pain and is worthy of clinical application.
展开▼
