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目的 探索心电图正常的患者的胸痛与ACS 诊断之间的关系.方法 对2017年1月-2018年12月就诊于本院急诊科(ED)表现胸痛且最初ECG 的正常患者的前瞻性观察性研究,其主诉入院接受了为期1年的胸痛评估.确定了两组:采集心电图期间出现胸痛的患者和采集心电图期间没有胸痛的患者.结果 129名患者符合研究标准.包括66 位男性(51％)和63 位女性(49％),平均年龄为56 岁(24-87 岁),其中35名(27％)患有已知的冠心病(CAD).共有87名(67％)患者在心电图期间经历了胸痛;42名患者(33％)在心电图检查期间未发生胸痛.两组在年龄,性别,心脏危险因素或已知的CAD 方面无差异.整个研究组的ACS 发生率为17％(22/129).根据是否存在胸痛,ACS 的患病率无差异(16％ 或14/87对19％ 或8/42;OR=0.79,95％ 置信区间=0.42 至1.35,P=0.41).结论 临床上疑似冠脉综合征在采集心电图时有无胸痛,ACS 的患病率无统计学意义的.换言之,建议患者胸痛时再行心电图检查并不能很好排除急性冠脉综合征,可能需更进一步临床检查比如动态心电图、平板试验、冠脉综合征等.“,”Purpose The purpose of this study is to explore the relationship between chest pain and the diagnosis of ACS in patients with normal ECG. Methods A prospective observational study of normal patients with chest pain and initial ECG presented to the emergency department (ED) of our hospital from January 2017 to December 2018. The chief complaint was admitted to the hospital for a 1-year chest pain assessment. Two groups were identified: patients with chest pain during ECG acquisition and patients without chest pain during ECG acquisition. Results 129 patients met the research criteria. Including 66 men (51％) and 63 women (49％), with an average age of 56 years (24-87 years), 35 (27％) of them have known coronary heart disease (CAD). A total of 87 patients (67％) experienced chest pain during the ECG; 42 patients (33％) did not experience chest pain during the ECG examination. There were no differences between the two groups in terms of age, gender, cardiac risk factors, or known CAD. The incidence of ACS in the entire study group was17％ (22/129). According to the presence or absence of chest pain, the prevalence of ACS was not different (16％ or 14/87 vs. 19％ or 8/42; OR=0.79, 95％ confidence interval=0.42 to 1.35, P=0.41). Conclusion Clinically, it is suspected that there is chest pain during the ECG collection of coronary syndrome, and the prevalence of ACS is not statistically significant. In other words, suggesting that patients undergo an ECG examination when they have chest pain cannot rule out acute coronary syndromes. Further clinical examinations such as Holter, treadmill test, coronary syndrome, etc. may be needed.