性别对急性ST段抬高型心肌梗死患者再灌注时间延迟的影响  

Analysis of reperfusion delay in patients with acute ST elevated myocardial infarction based on gender difference

作　　者：张中[1] 赵蓓[1] 魏腾飞[1] 刘佩林[1] 刘利峰[1] 刘莉[1] 赵京涛[1] 时全星[1] 殷召[1] 饶萌萌 毛帅[1] 王守力[1] ZHANG Zhong ZHAO Bei WEI Teng-fei LIU Pei-ling LIU Li-feng LIU Li ZHAO Jing-tao SHI Quan-xing YIN Zhao RAO Meng-meng MAO Shuai WANG Shou-li(Department of Cardiology, 306 Hospital of PLA, Beijing 100101j China)

机构地区：[1]解放军306医院心内科,北京100101

出　　处：《解放军医学杂志》2017年第2期144-148,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的分析解放军306医院心脏中心急性ST段抬高型心肌梗死(STEMI)救治体系中不同性别患者之间再灌注时间延迟的分布。方法纳入2011年1月-2015年12月解放军306医院连续急诊收治并符合入选标准的STEMI患者325例,依据性别不同分为男性组(268例)和女性组(57例),分析各急救时间,包括发病(SO)至首次医疗接触(FMC)时间(SO-to-FMC)、转运时间(FMC-to-D)、FMC-to-B、导管室启动延迟时间、介入操作延迟时间、急诊至球囊扩张血管再通时间(D-to-B)等,并观察预后。结果尽管女性患者的院前延迟时间中位数(160.0min)和So-to-FMC中位数(100.0min)较男性(分别为119.5min和69.5min)延长,但差异无统计学意义,其余各项再灌注延迟时间差异也无统计学意义(P>0.05)。女性患者合并高血压、糖尿病者比例较高,吸烟率明显低于男性(P<0.05);两组STEMI患者30d内和1年内的主要心脑血管不良事件(MACCE)发生率(男性5.22% vs 女性5.26%;男性10.82% vs 女性8.77%)差异无统计学意义(P>0.05)。结论性别因素对再灌注延迟的影响正逐渐弱化。Objective To examine the influence of gender difference on the reperfusion delay in patients with ST-elevation myocardial infarction（STEMI）. Methods A total of consecutive 325 patients with STEMI were analyzed admitted in the 306 Hospital of PLA from Jan. 2011 to Dec. 2015. Patients were divided into two groups： male group（n=268） and female group（n=57）. The clinical data and the time intervals including symptom onset to first medical contact（So-to-FMC）, transfer delay（FMC-to-D）, FMC to balloon dilatation（FMC-to-B）, activation delay and door to balloon（D-to-B） time were compared between different gender groups, and the prognosis was observed. Results The overall median of pre-hospital delay was 125 minutes. The median of prehospital delay time（male 119.5min vs. female 160.0min） and So-to-FMC time（male 69.5min vs. female 100.0min） were longer in female than in male patients, but no statistical difference existed（P〉0.05） between the two groups in pre-hospital delay, So-toFMC, FMC-to-B, D-to-B and total ischemia time. Compared with male patients, female patients were more likely to have additional comorbidities, such as hypertension and diabetes mellitus, and lower rate of smoking（P〈0.05）. However, the incidence of major adverse cardiac and cerebrovascular events（MACCE） showed no significant difference between female and male patients at 30-day（male 5.22% vs. female 5.26%） and 1-year（male 10.82% vs. female 8.77%） follow-up（P〉0.05）. Conclusion The influence of gender on reperfusion delay is gradually weakening.

关 键 词：心肌梗死 性别因素 再灌注延迟 

分 类 号：R542.22[医药卫生—心血管疾病]