给编辑:
我们通过Geibel兴趣地阅读纸等。1在ECG患者的预后价值急性主要肺栓塞(PE)。在过去的几年里,大量的研究,已经出版了的PE患者危险分层,用怀疑,有可能是血流动力学稳定的患者(PE次大面积)的一个子群,在其中溶栓可能是有益的2-4。
研究的假设1心电图可以作为一个简单的基线测试(与超声心动图相比)来确定PE患者的死亡风险。然而,本研究的人群包括血液动力学不稳定的PE患者(通常提示溶栓)和超声心动图检查发现的亚块状PE患者。因此,研究结果在临床应用上的价值有限。
我们研究了302名连续的血压正常的PE患者的2年期的诊断。The mean age was 68 yrs (95% confidence interval (CI): 66–70) of whom 55% were female. We analysed the prognostic relevance of ECG with respect to early mortality (defined as those presented in the first 30 days). ECG was available in 278 patients, of which 116 (42%) were normal. ECG abnormalities were: 1) sinus tachycardia in 93 patients; 2) ST-T abnormalities in 29 patients; 3) complete right bundle branch block in 42 patients; 4) S1Q3T3 pattern in 32 patients; 5) atrial arrythmia in 22 patients; and 6) right axis pattern in two patients. Early death occurred in 16 patients (6%). The 12-lead ECG did not show differences between survivors and nonsurvivors during the first 30 days after admission. Univariate analysis revealed that ECG abnormalities were not significant independent predictors of outcome (odds ratio: 0.7; 95% CI: 0.2–2.5). Our results do not support the usefulness of ECG for risk stratification in haemodynamically stable patients with pulmonary embolism.
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