ST段抬高型急性心肌梗死48h生存状态影响因素研究  

Explore the influencing factors of 48-hour survival status of STEMI patients

作　　者：吴延[1] 周孟君[1] WU Yan;ZHOU Mengjun(Department of Laboratory,Mianyang Central Hospital,Sichuan,Mianyang,710004,China)

机构地区：[1]绵阳市中心医院检验科,四川绵阳621000

出　　处：《临床急诊杂志》2018年第7期468-471,共4页Journal of Clinical Emergency

摘　　要：目的:了解ST段抬高型急性心肌梗死(STEMI)临床特点并探讨其48h生存状态的影响因素,为急性心肌梗死(AMI)患者院前急救提供理论依据。方法:本研究对绵阳市胸痛中心2013—2017年间收治的305例STEMI患者以查阅病历资料和数据库形式收集其资料,先进行单因素分析、筛选出有统计学意义的变量,将有意义的变量放入logistic回归模型进行Logistic多因素回归分析,探究影响STEMI患者48h生存状态的影响因素因素。结果:(1)经单因素分析结果显示不同Killip分级、年龄、不同发作距就诊时间、是否使用心肺复苏术的STEMI患者48h生存状态差异有统计学意义(P<0.05);(2)经Logistic多因素分析年龄、发作距就诊时间、心肺复苏术是STEMI患者48h预后的独立危险因素,而介入手术(PCI)治疗是保护因素。结论:不同Killip’s分级、年龄、不同发作距就诊时间、是否使用心肺复苏术的STEMI患者48h死亡发生率及预后有着重要的关系,是STEMI患者48h生存状态独立的预测因子,对临床急诊分诊有着重要的临床指导意义。Objective：To investigate the clinical characteristics of acute ST-segment elevation myocardial infarction（STEMI）and to explore the influencing factors of 48-hour survival status,then to provide theoretical basis for reducing prehospital first aid in patients with acute myocardial infarction（AMI）.Method：The data of 305 patients with STEMI admitted between 2013 and 2017 were analyzed.Then we use Logistic regression method to explore the impacts of STEMI patients＇ 48-hours survival status.Result：（1）The difference of 48-hours survival status of STEMI patients with different Killip grade was statistically significant（χ^2=16.884,P〈0.05）.（2）The difference of 48-hours survival status of heart attack STEMI patients from visiting time was statistically significant（χ^2=37.948,P〈0.05）.Whether or not cardiopulmonary resuscitation be used in STEMI patients,the difference of48-hourssurvival status was statistically significant（χ^2=5.133,P〈0.05）.Conclusion：When different Killip graded STEMI patients were divided,older patients should be earlier of the blood vessels associated with vascular revascularization,while shorten the delay of treatment time for heart attack STEMI patients from visiting time.In all,STEMI patients will be improved treatment effect when do these.

关 键 词：ST段抬高型急性心肌梗死 影响因素 发作距就诊时间 

分 类 号：R542.22[医药卫生—心血管疾病]