急性心肌梗死院前延误时间影响因素分析  

Analysis of factors associated with delayed time before treatment in patients with acute myocardial infarction

作　　者：郭路芬[1] 彭亚光[2] 程姝娟[1] 李庆祥[1] 赵冬[3] 洪昭光[1] 

机构地区：[1]首都医科大学附属北京安贞医院抢救中心,100029 [2]首都医科大学公共卫生与家庭医学学院 [3]北京市心肺血管病研究所流行病研究室

出　　处：《北京医学》2008年第1期20-22,共3页Beijing Medical Journal

摘　　要：目的探讨影响急性心肌梗死(AMI)患者院前延误时间(PDT)的相关因素。方法回顾性分析2004年3月至2006年10月北京安贞医院抢救中心收治的807例AMI患者的临床资料。将就诊时间与发病时间的时间差作为PDT,根据PDT将患者分为≤2h和﹥2h两组,分析年龄、性别、文化程度、吸烟、饮酒、高血压病史、糖尿病史、脑血管病史、冠心病或心绞痛史、来院时心率、血压、发病时间、季节、地点以及来院交通方式等因素对PDT的影响。结果PDT﹥2h组与PDT≤2h组比较,女性较多(114例,86例),年龄偏大[(62.0±12.9)岁,(59.0±12.9)岁],夜间发病者较多[136例(33.6%),103例(25.6%)],继往有糖尿病史者较多[114例(28.2%),87例(21.7%)]而吸烟者少[222例(55.9%),265例(66.9%)]。多元Logistic回归分析显示,年龄、糖尿病史、夜间发病和乘急救车来院就诊与患者院前延误相关(P﹤0.05)。结论年龄、糖尿病史、夜间发病以及乘急救车来院就诊是影响PDT的相关因素。加强患者及家属对AMI相关知识的认识、及时就诊,有助于AMI患者的救治及AMI患者病死率的降低。Objective To investigate the factors associated with prehospital delayed time （PDT） in patients with acute myocardial infarction （AMI）. Methods We retrospectively analyzed 807 patients with acute myocardial infarction sent to the Emergency Ward and Emergency Intensive Care Unit （EICU） of Beijing Anzhen Hospital from March 2004 to October 2006. All patients were divided into 2 groups according to PDT, that was PDT≤2h and PDT 〉 2h. Factors including age, gender, educational status, smoking, alcohol use, hypertension, diabetes mellitus, stroke, coronary artery disease, heart rate and blood pressure on arrival, onset at night, onset season, onset situation and traffic were analyzed. Results Patients with PDT 〉 2h were older than those with PDT≤2h. There were more female patients, more patients with diabetes mellitus and more nocturnal onset in the patients with PDT 〉 2h than those with PDT≤2h （P〈 0.05）. Logistic regression showed that age, diabetes mellitus, onset at night and visiting by ambulance were the associated factors with PDT. Conduslons Factors such as age, gender, diabetes mellitus, smoking, onset at night, onset situation and traffic alternatives are associated with PDT. Age, diabetes mellitus, onset at night and visiting by ambulance are the associated factors with PDT. Coronary revascularization including thrombolysis and PCI as early as possible after onset of AMI is the key factors that impacts the prognosis of patients with AMI.

关 键 词：急性心肌梗死 院前延误时间 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]