电心电图是否应用于指导左结枝阻塞和疑似心肌梗塞患者的治疗?
M G Shlipak1, W L Lyons, A S Go
1Veterans Affairs Medical Center, Department of Medicine, University of California, San Francisco 94121, USA.
JAMA
|March 3, 1999
概括
电心电图 (ECG) 算法不能可靠地预测心肌梗塞 (MI) 在患有左束支部阻塞 (LBBB) 的患者. 应考虑对所有LBBB患者进行血栓缓解疗法,这些患者有暗示心脏病的症状.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 诊断算法 诊断算法
背景情况:
- 一种心电图 (ECG) 算法被开发用于预测心肌梗塞 (MI) 在患有左束分支阻塞 (LBBB) 的患者.
- 这种心电图算法的临床影响和诊断实用性在很大程度上是未知的.
研究的目的:
- 为了评估心电图算法对LBBB患者的MI的诊断测试特征.
- 评估心电图算法的临床实用性,以指导怀疑心脏病发作的治疗决策.
主要方法:
- 回顾性队列研究涉及患有LBBB和暗示心脏病的症状的患者.
- 应用特定的心电图算法来预测MI.
- 决策分析比较由算法指导的血栓溶解与标准护理.
主要成果:
- 电脑心电图算法在识别心脏病发作时表现出低灵敏度 (10%).
- 评估的ECG发现中没有一个有效地区分MI与该队列中的其他诊断.
- 决策分析表明,胸痛LBBB患者的全方位血栓溶解与使用心电图算法作为查工具相比,导致更好的生存结果.
结论:
- 电脑心电图算法是LBBB患有急性心肺症状的患者心脏病发作的一个不可靠的预测指标.
- 应强烈考虑对所有患有LBBB且出现与MI一致的症状的患者进行急性血栓抑制疗法.
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