急性ST段抬高心肌梗死患者院内死亡发生率的相关因素分析：冠心病介入治疗数据库资料  

Analysis of the factor in death rate in hospital of patients with ST-segment elevation myocardial infarction: An analysis of data from Cardiovascular Intervention Procedures Database

作　　者：韩雅玲[1] 王海昌[2] 陈韵岱[3] 黄岚[4] 丁世芳[5] 吴宗贵[6] 祝之明[7] 向定成[8] 姜铁民[9] 赵仙先[10] 杨丽霞[11] 王冬梅[12] 刘惠亮[13] 宋治远[14] 曹雪滨[15] 荆全民[1] 李毅[1] 柏书轶 徐凯[1] 军队心血管疾病介入诊疗质控委员会 

机构地区：[1]沈阳军区总医院心内科,沈阳110016 [2]第四军医大学西京医院心内科,西安710032 [3]解放军总医院心内科,北京100853 [4]第三军医大学新桥医院心内科,重庆400037 [5]广州军区武汉总医院心内科,武汉430070 [6]第二军医大学长征医院心内科,上海200003 [7]第三军医大学大坪医院高血压内分泌科,重庆400042 [8]广州军区总医院心内科,广州510010 [9]武警后勤学院附璃医院心内科,天津300162 [10]第二军医大学长海医院心内科,上海200433 [11]成都军区昆明总医院心内科,昆明650032 [12]白求恩国际和平医院心内科,石家庄130100 [13]武警总医院心内科,北京100039 [14]第三军医大学西南医院心内科,重庆400038 [15]解放军252医院心内科,保定072250 [16]不详

出　　处：《解放军医学杂志》2015年第4期262-265,共4页Medical Journal of Chinese People's Liberation Army

基　　金：国家“十二五”科技支撑计划课题(2011BAI11B07)~~

摘　　要：目的探讨急性ST段抬高心肌梗死（STEMI）患者发病到血管开通时间与院内死亡发生率的关系。方法分析军队心血管疾病介入诊疗直报系统数据,其中包括冠心病介入治疗资料。研究终点为院内死亡发生率,通过患者年龄及心梗部位进行分层,探讨这两个因素对患者院内死亡发生率的影响。结果全军92家医院行急诊介入治疗的8878例STEMI患者入选本研究。根据从发病到罪犯血管开通的时间将患者分为3组：开通时间≤3h（n=2999）、开通时间3~6h（n=2369）及开通时间〉6h（n=3510）。3组患者的院内死亡发生率分别为2.5%、2.9%和3.0%（P=0.405）。其中非前壁心肌梗死且年龄〈50岁的患者,若发病3h内接受介入治疗,院内死亡发生率为0.5%;若患者为前壁心肌梗死且年龄〉70岁,超过6h才接受介入治疗,则院内死亡发生率可高达7.4%,两者比较差异有统计学意义（P〈0.001）。结论 STEMI患者院内死亡发生率与罪犯血管开通时间相关,老年及前壁心梗患者是院内死亡的高危人群。Objective To explore the relationship between symptom-onset-to-balloon time and in-hospital mortality in patients with ST elevation myocardial infarction （STEMI）. Methods Since October 2010, all cardiovascular intervention procedures in military hospitals were registered online, including coronary interventions. Data in this study were originated from this registry database. Primary endpoint was in-hospital mortality, and it was stratified by age and infarction location to explore the effects of these factors on the mortality rate. Results 8878 STEMI patients from 92 military medical centers were enrolled in this study. These patients were divided into 3 groups by the length of onset-to-vessel opening time： interval ≤ 3h （n=2999）, interval between 3 and 6h （n=2369）, and interval 〉6h （n=3510）. The in-hospital mortality rate in those groups was 2.5%, 2.9% and 3.0%, respectively （P=0.405）. In interval ≤3h group, mortality rate in young （〈50 years） patients with non-anterior MI was 0.5%, while mortality rate in old （〉70 years） patients with anterior MI was as high as 7.4% （P〈0.001）. Conclusions In-hospital mortality rate in STEMI patients is related to onset-to-vessel opening time. Patients with old age or anterior MI are a high-risk cohort.

关 键 词：心肌梗死 医院死亡率 血管开通时间 

分 类 号：R541.4[医药卫生—心血管疾病]