论文部分内容阅读
目的 :前瞻性研究症状对不同性别急性冠状动脉综合征 (ACS)的诊断是否有预测价值。方法 :2 0 0 0年 1月 1日～ 2 0 0 3年 3月 31日 ,我们对连续拟诊ACS行急诊冠状动脉介入的 74 0例患者进行了观察 ,男 5 2 8例 ,女 2 12例 ,对比分析男女患者的预测症状。结果 :根据心电图、心脏标志物和冠状动脉造影 ,最后诊断为ACS女性 184例 ( 86 .8% ) ,男性 4 80例 ( 90 .9% )。女性有典型症状 (胸痛或不适、呼吸困难、出汗、臂或肩痛 )者诊断为ACS明显多 ,男性则不 ;相反 ,女性有不典型症状者诊断ACS不多 ,而在男性 ,一些不典型症状 (头晕或头昏 )与ACS的诊断呈反相关系 (P <0 .0 5 )。多因素分析表明 ,出汗 (P <0 .0 5 )和胸痛 (P >0 .0 5 )与女性ACS的诊断呈显著或边缘相关 ;而胸痛等典型症状与男性ACS无明显相关 ( P >0 .0 5 )。与男性相比 ,有典型症状的女性诊断ACS的调整相对危险性接近 1.0 ,提示无性别差异。结论 :典型症状是诊断女性ACS的最强症状预测因素 ,与男性一样重要
OBJECTIVE: To prospectively investigate whether symptoms have predictive value in the diagnosis of different gender acute coronary syndromes (ACS). Methods: From January 1, 2000 to March 31, 2003, we observed 74 0 consecutive patients undergoing emergency coronary intervention in ACS. There were 528 males and 2 females 12 cases, comparative analysis of the predicted symptoms of male and female patients. Results: Based on electrocardiogram, cardiac markers and coronary angiography, 184 (86.8%) were diagnosed in ACS and 48 (90.9%) were men. Female patients with typical symptoms (chest pain or discomfort, dyspnea, sweating, arm or shoulder pain) were diagnosed as having significantly more ACS than men; on the contrary, women with atypical symptoms were diagnosed with few ACSs, whereas in men, some were not Typical symptoms (dizziness or dizziness) were inversely related to the diagnosis of ACS (P <0.05). Multivariate analysis showed that there was a significant or borderline correlation between sweating (P <0.05) and chest pain (P> 0.05), but there was no significant correlation between the typical symptoms such as chest pain and ACS in men (P> 0 .0 5). In women with typical symptoms, the relative risk of adjustment for ACS is close to 1.0, suggesting no gender differences compared with men. CONCLUSIONS: The typical symptoms are predictors of the strongest symptoms of female ACS and are as important as men’s