节假日对ST段抬高心肌梗死院内再灌注延迟的影响  

Effect of holidays on door-to-reperfusion time in patients with ST-segment elevation myocardial infarction

作　　者：刘书山[1] 胡大一[2] 杨进刚[1] 孙艺红[2] 宋莉[1] 王冉冉[1] 张清潭[1] 杜兰芳[1] 李超[1] 赵薇[1] 

机构地区：[1]首都医科大学附属同仁医院心脏中心,100730 [2]北京大学人民医院心内科,100044

出　　处：《中国介入心脏病学杂志》2008年第2期91-94,共4页Chinese Journal of Interventional Cardiology

基　　金：首都紧急医学救援(5分钟)科技工程建设研究项目[京科技发(2005)593]资助

摘　　要：目的多中心、前瞻性观察节假日对急性ST段抬高心肌梗死(ST-elevation myocardial infarction,STEMI)患者院内再灌注延迟的影响。方法连续入选在北京市19个医疗中心自2005年11月至2006年7月至急诊室就诊并接受再灌注的STEMI患者共297例。分为节假日(春节、劳动节、国庆节、元旦、周末)和非节假日(星期一至星期五)再灌注治疗组。与非节假日再灌注治疗相比,分析节假日对进入医院门口(进门)-再灌注延迟的影响。结果297例患者中,节假日再灌注治疗组94例(31.6%),其中26例患者接受溶栓治疗,68例患者接受急诊PCI;非节假日再灌注治疗组203例(68.4%),其中61例患者接受溶栓治疗,142例患者接受PCI。在校正患者的各项因素后,节假日与进门-球囊扩张时间中位数[162.2min(95%CI:160.8,165.3)比141.8min(95%CI:137.8,144.1);P<0.01]及进门-溶栓时间中位数[64.1min(95%CI61.9,66.5)比50.1min(95%CI:48.3,54.5);P=0.03]延长显著相关。结论北京市在节假日接受再灌注治疗的STEMI患者进门-再灌注时间延迟增加。Objective To evaluate the effect of holidays on door-to-reperfusion time in patients with ST-segment elevation myocardial infarction （STEMI）. Methods Using the data from the Registry of ST- segment elevation Myocardial Infarction in Beijing, we studied the data of 297 patients with STEMI who received acute reperfusion from November 2005 to July 2006. The association between holidays and door-toreperfusion time in these patients was studied. Results Ninty four patients in this study were admitted in holidays （26 of them received fibrinolytic therapy and 68 received PCI） and the other 203 patients were admitted during routine weekdays （61 of them received fibrinolytic therapy and 142 received PCI）. After adjusting for patient characteristics, admission during holidays was associated with a longer median door-toballoon time [ 162. 2 min （95% CI： 160. 8,165.3） vs 141.8 min （95% CI： 137. 8,144. 1 ） ; P 〈0. 01 ] and longer median door-w-drug time [64. 1 min （95% CI： 61.9,66. 5） vs 50. 1 min （95% CI： 48.3, 54. 5 ） ; P = 0. 03 ] compared with patients admitted during weekdays. Conclusion Holiday is an important factor associated with prolonged door-to-reperfusion time in observed Beijing.

关 键 词：心肌梗死 心肌再灌注 假日 时间安排 

分 类 号：R542.220.5[医药卫生—心血管疾病] R542.22[医药卫生—内科学]