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JAMA Intern Med：性别特异性胸痛特征不适用于急性心梗早期诊断

2013-11-28 高晓方 译 医学论坛网

性别特异性胸痛特征急性心梗
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瑞士一项研究表明，胸痛特征（CPC）的性别特异性差异较小，因此女性特异性CPC不适用于急性心梗的早期诊断。论文11月25日在线发表于《美国医学会杂志·内科学》（JAMA Intern Med）。 此项研究共纳入2475例就诊于急诊科的急性胸痛患者，其中男性和女性分别为1679和796例。由两位独立心内科医生做出急性心梗的最终诊断。主要转归指标为34项CPC在急性心梗早

瑞士一项研究表明，胸痛特征（CPC）的性别特异性差异较小，因此女性特异性CPC不适用于急性心梗的早期诊断。论文11月25日在线发表于《美国医学会杂志·内科学》（JAMA Intern Med）。

此项研究共纳入2475例就诊于急诊科的急性胸痛患者，其中男性和女性分别为1679和796例。由两位独立心内科医生做出急性心梗的最终诊断。主要转归指标为34项CPC在急性心梗早期诊断中的性别特异性诊断价值。

结果显示，分别有143例女性（18.0%）和369例男性（22.0%）得出急性心梗最终诊断。尽管在男、女性患者中大部分CPC的报告频率基本相似，但数项CPC在女性中报告更为频繁。在男、女性患者中大部分CPC诊断急性心梗的准确性均较低，似然比接近1。仅3项CPC（8.8%）似乎具有性别特异性诊断价值，并与疼痛持续时间（2～30分钟和>30分钟）和动态变化（疼痛强度降低）相关。然而，由于似然比接近1，因此上述3项CPC对临床并无帮助。

原文出处：

Maria Rubini Gimenez; Miriam Reiter; Raphael Twerenbold; Tobias Reichlin; Karin Wildi; Philip Haaf; Katharina Wicki; Christa Zellweger; Rebeca Hoeller; Berit Moehring; Seoung Mann Sou; Mira Mueller; Kris Denhaerynck; Bernadette Meller; Fabio Stallone; Sarah Henseler; Stefano Bassetti; Nicolas Geigy; Stefan Osswald; Christian Mueller.Sex-Specific Chest Pain Characteristics in the Early Diagnosis of Acute Myocardial Infarction.JAMA Intern Med. Published online November 25, 2013. doi:10.1001/jamainternmed.2013.12199

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    2014-03-28 jinweidong

    #特异性#

    0

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    2013-11-30 chenlianhui

    #急性心梗#

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    2013-11-30 一叶知秋

    #早期诊断#

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    2013-11-30 ms3994565386320060

    #Med#

    0