【摘要】 目的量化分析心源性胸痛患者的影响因素,为正确分诊提供参考。方法将1 514例急性非创伤性胸痛患者,按最终诊断分为心源性胸痛组（476例）和非心源性胸痛组（1 038例）,对两组一般资料、相关疾病、MEWS评分、疼痛评分,血氧饱和度（SpO₂）等指标进行单因素分析、Logistic回归及ROC曲线分析。结果两组性别、年龄、民族、高血压、糖尿病、冠心病、MEWS评分、疼痛评分及SpO₂值比较,差异有统计学意义（P<0.05,P<0.01）;Logistic回归分析显示上述9项中除民族、糖尿病外,另7项是心源性胸痛的危险因素（OR=1.015～1.810,P<0.05,P<0.01）;ROC曲线诊断效能分析显示,年龄48.50岁、MEWS评分2.50分、疼痛评分2.50分、SpO₂ 0.88为心源性胸痛危险因素的截点值。结论对胸痛急诊患者,应结合年龄、MEWS评分、疼痛评分、SpO₂综合判断是否存在心源性胸痛风险,避免漏诊。更多还原

【Abstract】 Objective To identify predictors of cardiogenic pain and to provide reference for triage. Methods A total of 1 514 patients with acute non-traumatic chest pain were recruited: 476 with cardiogenic pain and 1 038 with non-cardiogenic pain. Sociodemographic data, related diseases, MEWS score, pain score and SpO₂ value were collected and analyzed using univariate analysis, Logistic regression and ROC curve analysis. Results There were significant differences between the two groups in gender, age, nationality, presence of hypertension/diabetes/coronary heart disease, MEWS score, pain score, and SpO₂ value（P<0.05, P<0.01）. Logistic regression analysis showed that except nationality and presence of diabetes, the above 7 indicators were risk factors of cardiogenic pain（OR=1.015-1.810, P<0.05,P<0.01）. The ROC curve indicated the cutoff values of age, MEWS score, pain and SpO₂ to predict cardiogenic pain were 48.50, 2.50, 2.50, and 0.88, respectively. Conclusion Nursing staff should assess patients with acute chest pain by considering their age, MEWS score, pain score and SpO₂ value, thus to identify whether they have a risk of cardiogenic pain and to avoid the probability of missed diagnosis.更多还原