区域性胸痛中心建设对ST段抬高型心肌梗死治疗的影响  

Effects of establishment of a regional chest pain center on the treatment of patients with ST-segment elevated myocardial infarction

作　　者：张国新[1] 李长顺[1] 李恒涛 高丽娟 李庚 张献辉[1] 

机构地区：[1]上海交通大学医学院附属苏州九龙医院急救中心,苏州215021

出　　处：《中国急救复苏与灾害医学杂志》2017年第10期944-947,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨区域性胸痛中心建设对sT段抬高型心肌梗死（ST-segment elevated myocardial infarction,sTEMI）救治时间及效果的影响。方法回顾性分析了2012年1月一2016年12月苏州九龙医院急救中心收治的STEMI急诊PPCI患者214例的临床病例。这些患者分为胸痛中心建设前组（95例）和胸痛中心建设后组（119例），分别记录两组患者发病一球囊扩张（symptoms to intra-aortic balloon inflation, S2B）、首次医疗接触-球囊扩张（intra-aortic balloon inflation, FMC2B）、入门-球囊扩张（ intra-aortic balloon inflation, D2B）时间变化，同时记录患者90d终点事件的发生率。结果胸痛中心建设前后的S2B中位时间分别是192min和180min，差异有统计学意义（P=0．041）。胸痛中心建设前后的FMC2B中位时间分别为98min和93min，差异有统计学意义（P=0．035）。胸痛中心建设前后的D2B中位时间分别为94min和67min，差异有统计学意义（P=0．000）。胸痛中心建设后患者随访90d终点事件的发生率较胸痛中心建设前患者明显降低，差异有统计学意义（P〈0．05）。结论区域性胸痛中心建设能有效缩短急性sT段抬高性心肌梗死救治时间，减少急性心肌梗死终点事件的发生率。Objective To investigate the effects of establishment of a regional chest pain center on the treatment time and ＇efficacy in patients with ST-segment elevated acute myocardial infarction （STEMI）. Methods A total of 214 STEMI patients who underwent primary percutaneous coronary intervention （PPCI） in our department from January 2012 to December 2016 were enrolled into the current study. Their clinical data were analyzed retrospectively. The patients were divided into two groups according to their admission time before and after establishment of the center. Both groups were observed for the changes in the time from onset of symptoms to intra-aortic balloon inflation （S2B）, from the first medical contact （FMC） to intra-aortic balloon inflation （FMC2B）, from entering into the hospital to intra-aortic balloon inflation （D2B）. Meanwhile, their incidence of 90 day end point events was recorded. Results The median S2B was 192 and 182 rain before and after establishment, respective/y, which were statistically different. （P= 0.041）. The median FMC2B was 98 and 93 min before and after establishment, respectively, which were statistically different （P=-0.035）. The median FMC2B was 94 and 67 rain before and after establishment, respectively, which were statistically different （P=0.000）. The incidence of 90 day end point events was lower in patients admitted after establishment than those before establishment （P〈0.05）. Conclusion The establishment of the regional ehest pain center can effectively shorten the treatment time and the incidence of end point events in STEMI patients.

关 键 词：ST段抬高型心肌梗死 再灌注时间 90天终点事件 胸痛中心 

分 类 号：R541.4[医药卫生—心血管疾病]