Zègre Hemsey Jessica K, Dracup Kathleen, Fleischmann Kirsten, Sommargren Claire E, Drew Barbara J
School of Nursing, University of California, San Francisco, CA, USA.
J Electrocardiol. 2012 May-Jun;45(3):266-71. doi: 10.1016/j.jelectrocard.2011.10.004. Epub 2011 Nov 23.
AIMS/METHODS: We studied 620 patients who activated "911" for chest pain symptoms to determine the sensitivity and specificity of 12-lead electrocardiogram (ECG) ST-segment monitoring in the prehospital period (PH ECG) for diagnosing acute coronary syndrome (ACS) and to assess whether the addition of PH ECG signs of ischemia/injury to the initial hospital 12-lead ECG obtained in the emergency department would improve the diagnosis of ACS.
The sensitivity and specificity of the PH ECG were 65.4% and 66.4%. There was a significant increase in sensitivity (79.9%) and decrease in specificity (61.2%) when considered in conjunction with the initial hospital ECG (P < .001). Those with PH ECG ischemia/injury were more than 2.5 times likely to have an ACS diagnosis than those who had no PH ECG ischemia/injury (P < .001).
Prehospital ECG data obtained with 12-lead ST-segment monitoring provides diagnostic information about ACS above and beyond the initial hospital ECG.
目的/方法：我们研究了620例因胸痛症状拨打“911”的患者，以确定院前12导联心电图（ECG）ST段监测（PH ECG）对诊断急性冠状动脉综合征（ACS）的敏感性和特异性，并评估在急诊科获得的初始院内12导联ECG基础上增加PH ECG缺血/损伤迹象是否会改善ACS的诊断。
PH ECG的敏感性和特异性分别为65.4%和66.4%。与初始院内ECG联合考虑时，敏感性显著提高（79.9%），特异性降低（61.2%）（P <.001）。有PH ECG缺血/损伤的患者被诊断为ACS的可能性是没有PH ECG缺血/损伤患者的2.5倍多（P <.001）。
通过12导联ST段监测获得的院前ECG数据提供了超出初始院内ECG的有关ACS的诊断信息。
