改良早期预警评分结合心电图SaO<sub>2</sub>在评价 急性胸痛患者病情严重程度中的临床价值

doi:10.3969/j.issn.1006-6233.2019.04.006

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摘要目的:探究改良早期预警评分(MEWS)结合心电图、血氧饱和度(SaO₂)在评价急性胸痛患者病情严重程度中的临床价值。方法:以2017年9月至2018年9月急诊科接诊的1080例急性胸痛患者为研究对象,进行MEWS评分和MEWS结合心电图、SaO₂评分,并安排专人负责追踪患者预后,采用Cox回归模型进行生存分析。结果:预后越差的患者MEWS评分及联合评分越高,差异有统计学意义(P<0.05);且住ICU及急诊死亡患者联合评分显著高于MEWS评分,差异有统计学意义(t=3.241,4.006,P<0.05);Cox回归生存分析结果显示,MEWS评分(P=0.038)、心电图评分(P=0.022)、SaO₂评分(P=0.015)及联合评分(P=0.014)均为急性胸痛患者死亡的独立危险因素,其中联合评分(HR=3.720)对患者预后死亡的预测价值更高。结论:MEWS评分结合心电图、SaO₂监测有助于及时、准确评价急性胸痛患者病情严重程度,预测潜在风险,值得推广应用。

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关键词 ：改良早期预警评分, 心电图, 血氧饱和度, 急性胸痛

Abstract：Objective: To explore the clinical value of modified early warning score (MEWS) combined with electrocardiogram (ECG) and blood oxygen saturation (SaO₂) in evaluating the severity of acute chest pain. Methods:A total of 1080 patients with acute chest pain received in the emergency department from September 2017 to September 2018 were studied. MEWS score and MEWS combined with electrocardiogram and SaO₂ score were performed. A special person was assigned to follow up the prognosis of patients. Cox regression model was used for survival analysis. Results:The worse the prognosis, the higher the MEWS score and the combined score, the difference was statistically significant (P<0.05). The combined scores of ICU and emergency death patients were significantly higher than those of MEWS (t = 3.241, 4.006, P<0.05). Cox regression survival analysis showed that MEWS score (P=0.038), electrocardiogram score (P=0.022), SaO₂ score (P=0.015) and combined score (P=0.014) were all independent risk factors for death of patients with acute chest pain, and the combined score (HR=3.720) had higher predictive value for prognosis death of patients. Conclusion: MEWS score combined with electrocardiogram and SaO₂ monitoring can help to timely and accurately evaluate the severity of acute chest pain and predict potential risks.

Key words： Modified early warning score Electrocardiogram Blood oxygen saturation Acute chest pain

基金资助:广西医药卫生科研课题,(编号:桂卫Z2010102)

引用本文:

曾宇, 麦泉云, 欧阳后华, 杨新疆, 罗乃琨. 改良早期预警评分结合心电图SaO₂在评价急性胸痛患者病情严重程度中的临床价值[J]. 河北医学, 2019, 25(4): 548-550.
ZENG Yu, MAI Quanyun, OUYANG Houhua, et al. Clinical Value of Modified Early Warning Score combined with Electrocardiogram and SaO₂ in Evaluating the Severity of Acute Chest Pain. HeBei Med, 2019, 25(4): 548-550.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.04.006 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I4/548