摘要
目的探讨D-二聚体在急诊胸痛中心早期鉴别诊断急性主动脉综合征(AAS)的重要性,以及讨论如何结合D-二聚体检测优化现有胸痛中心的急救流程。方法收集近1年来我院胸痛中心收治的50例以胸痛为主诉的患者资料,其中25例最终确诊AAS的患者作为AAS组,以同一时期诊治的25例进行了急诊经皮冠状动脉介入治疗(PCI)确诊的急性非ST抬高型心肌梗死(NSTEMI)患者作为对照组。所有患者在首诊时检测血D-二聚体,通过绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),分析D-二聚体对AAS与NSTEMI的鉴别诊断价值,并探讨其优化胸痛中心救治流程的实际意义。结果AAS组D-二聚体水平明显高于NSTEMI组,差异具有统计学意义(P<0.001),且在D-二聚体为89500μg/L时取得最佳截止点。结论对于胸痛患者早期鉴别诊断,D-二聚体具有重要参考价值。
Objective To explore the importance of D-dimer in early differential diagnosis of acute aortic syndrome(AAS)in the emergency chest pain center.And to discuss how to combine D-dimer detection with optimizing the first aid process of existing chest pain centers.Methods The data of 50 patients who complained of chest pain in the chest pain center of our hospital in the past 1 year was collected,including 25 patients who were finally diagnosed as AAS group.Other 25 patients with acute non-ST elevation myocardial infarction(NSTEMI)diagnosed by emergency percutaneous coronary intervention(PCI)were included as control group.Blood D-dimer was detected in all patients at the first visit.By drawing receiver operating characteristic curve(ROC),the value of D-dimer in differential diagnosis between AAS and NSTEMI was analyzed,and the practical significance of optimizing the treatment process of chest pain center was discussed.Results The level of D-dimer in AAS group was significantly higher than that in NSTEMI group(P<0.001),and the best cutoff point was obtained when D-dimer was 895.00μg/L.Conclusion D-dimer has reference significance for early differential diagnosis of patients with chest pain.
作者
关天悦
关志斌
GUAN Tianyue;GUAN Zhibin(Emergency Department,Guangzhou First People's Hospital,Guangzhou 510180,China)
出处
《广州医药》
2021年第4期112-116,共5页
Guangzhou Medical Journal
