发病至首次医疗接触时间对急性ST段抬高型心肌梗死患者进门至球囊扩张时间的影响研究  

Impact of symptom onset-first medical contact on door-to-balloon time in patients with acute ST-segment elevation myocardial infarction

作　　者：刘佩林[1] 刘莉[1] 赵京涛[1] 宋洪勇[1] 赵蓓[1] 冯雪瑶[1] 刘利峰[1] 刘瑛琪[1] 毛帅[1] 周莉[1] 夏会会 高铁山[1] 王守力[1] 

机构地区：[1]解放军306医院心内科,北京100101

出　　处：《中国实用内科杂志》2014年第11期1109-1111,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者发病至首次医疗接触(SO-to-FMC)时间对进门至球囊扩张(D-to-B)时间的影响。方法回顾性研究2011年8月至2014年9月由救护车送入解放军第306医院,发病12h内接受直接经皮冠状动脉介入治疗(PCI)的STEMI患者149例。记录如下时间:SO-to-FMC、首次医疗接触至进门、D-to-B、发病至球囊扩张。分为SO-to-FMC≤60 min组(82例)和SO-to-FMC>60 min组(67例)。结果 149例患者SO-to-FMC中位时间(P25,P75)为60(40,105)min;SO-to-FMC≤60 min组D-to-B时间达标率显著高于SO-toFMC>60 min组(35.3%对19.4%,P=0.000),D-to-B时间明显短于SO-to-FMC>60 min组(中位时间95 min对114 min,P<0.05),总缺血时间显著短于SO-to-FMC>60 min组(中位时间179 min对273 min,P<0.05);两组首次医疗接触至进门时间(中位时间26 min对25 min,P=0.852)差异无统计学意义。结论 SO-to-FMC时间越短即越早寻求医疗干预,D-to-B及总缺血时间也随之越短,因此SO-to-FMC时间可作为STEMI患者急救的新时间指标。Objective To investigate the impact of symptom onset-first medical contact（ Symptom Onset-First Medical Contact,SO-to-FMC） on the door-to-balloon（ D-to-B） time in patients with acute ST-segment elevation myocardial infarction（ ST elevated myocardial infarction,STEMI）. Methods The retrospective study of a single-center; selected 149 STEMI patients sent by ambulance from 2011. 08 to 2014. 09,and all accept primary percutaneous coronary intervention（ percutaneous coronary intervention,PCI） within 12 h after symptom onset. Record the following times： symptom onset-first medical contact,the first medical contact-the door,the door-to-balloon,symptom onset-balloon. Patients were divided into two groups： SO-to-FMC≤60 min group and SO-to-FMC〉60 min groups. Results In the 149 STEMI patients,the median（ 25%,75%） of SO-to-FMC time was 60（ 40,105） min; the standard rate of D-to-B time（ D-to-B≤90 min） in SO-to-FMC≤60 min group was significantly higher than SO-to-FMC〉60 min group（ 35. 3% vs 19. 4%,P = 0. 000）; the D-to-B time was shorter than the SO-to-FMC〉60 min group（ median 95 min vs 114 min,P〈0. 05）; total ischemic time was significantly shorter than SO-to-FMC〉60 min group（ median 179 min vs 273 min,P〈0. 05）; first medical contact-door time of the two groups（ median 26 min vs 25 min,P = 0. 852） was not statistically significant different. Conclusion The shorter of the SO-to-FMC time of patients seek medical intervention earlier,D-to-B and total ischemic time also would be shorter,and therefore SO-to-FMC time could be as a new indicator in the emergency of patients with STEMI.

关 键 词：心肌梗死 发病至首次医疗接触 进门至球囊扩张时间 

分 类 号：R5[医药卫生—内科学]