Fisher M L, Kelemen M H, Collins D, Morris F, Moran G W, Carliner N H, Plotnick G D
Arch Intern Med. 1983 Aug;143(8):1541-3.
To determine the cost-effectiveness of routine use of serial SGOT, lactic dehydrogenase (LDH), and LDH isoenzyme determinations in patients with suspected acute myocardial infarction (AMI), 166 consecutive patients admitted to a coronary care unit were prospectively identified and clinical findings analyzed independently using predetermined criteria. Based on chest pain characteristics, ECG, and creatine kinase--MB (CK-MB) results, patients were placed in categories of definite AMI (31%), possible AMI (34%), or AMI excluded (36%). The SGOT and/or LDH patterns were considered positive (ie, suggestive of AMI) in 82% of the patients with definite AMI but only confirmed CK-MB results. Positive SGOT/LDH results yielded new clinically relevant information in only 14 patients (8%). Total charges for SGOT/LDH determinations in these 166 patients totaled $10,938 or approximately $780 for each additional clinically important positive result. When serial ECG and CK-MB results are available, routine serial SGOT/LDH determinations are not justified.
为了确定对疑似急性心肌梗死（AMI）患者常规进行系列谷草转氨酶（SGOT）、乳酸脱氢酶（LDH）及LDH同工酶检测的成本效益，前瞻性地确定了166例连续入住冠心病监护病房的患者，并使用预定标准对临床发现进行独立分析。根据胸痛特征、心电图及肌酸激酶同工酶MB（CK-MB）结果，将患者分为确诊AMI（31%）、可能AMI（34%）或排除AMI（36%）类别。在确诊AMI的患者中，82%的患者SGOT和/或LDH模式被视为阳性（即提示AMI），但仅通过CK-MB结果得以证实。SGOT/LDH阳性结果仅在14例患者（8%）中产生了新的临床相关信息。这166例患者的SGOT/LDH检测总费用为10,938美元，即每一个额外的具有临床重要意义的阳性结果约为780美元。当有系列心电图和CK-MB结果时，常规系列SGOT/LDH检测是不合理的。
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