急性ST段抬高型心肌梗死患者的临床特征及接受急诊经皮冠状动脉介入治疗的影响因素  

Clinical characteristics of patients with acute ST-segment elevation myocardial infarction and influencing factors of receiving emergency percutaneous coronary intervention treatment

作　　者：沈印[1] 朱良峰[1] 吕立文[1] 伍广伟[2] 陈万[1] 曾希[1] 朱瑞凯[1] 石磊[1] SHEN Yin;ZHU Liang-feng;LU Li-wen;WU Guang-wei;CHEN Wan;ZENG Xi;ZHU Rui-kai;SHI Lei(Department of Emergency Medicine,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Department of Cardiovascular Medicine,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院急诊科,南宁市530021 [2]广西壮族自治区人民医院心血管内科,南宁市530021

出　　处：《广西医学》2019年第15期1941-1945,共5页Guangxi Medical Journal

基　　金：广西科学研究与技术开发计划(桂科攻14124004-1-6);广西医药卫生科研课题(Z20170368)

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者的临床特征及接受急诊经皮冠状动脉介入(PCI)治疗的影响因素。方法回顾性分析1186例急性STEMI患者的临床资料,分析患者的临床特点,以及患者接受PCI治疗的影响因素。结果1186例STEMI患者中,行急诊PCI治疗521例(43.9%),保守治疗665例(56.1%);以男性老年人为主,临床表现以胸痛常见,常伴有心律失常,发病部位主要为前壁及广泛前壁。多因素分析结果显示,年轻、既往有高血压病史、高脂血病病史、心血管疾病病史、心血管疾病家族史、AMI部位及发病时出现胸痛症状是影响STEMI患者接受急诊PCI治疗的因素(均P<0.05)。结论STEMI患者接受急诊PCI治疗率较低,年龄、AMI部位为前壁、胸痛明显以及既往有高血压病史、高血脂病史、心血管疾病病史、心血管疾病家族史、AMI部位及发病时出现胸痛症状的急诊STEMI患者,更倾向于接受急诊PCI。Objective To explore the clinical characteristics of patients with acute ST-segment elevation myocardial infarction(STEMI)and the influencing factors of receiving emergency percutaneous coronary intervention(PCI)treatment.Methods The clinical data of 1 186 patients with acute STEMI were analyzed retrospectively,the clinical characteristics of the patients were analyzed,and the influencing factors of patients′receiving PCI treatment were analyzed.Results Of 1 186 patients with STEMI,521(43.9%)received emergency PCI treatment,and 665(56.1%)received conservative treatment;the condition mainly occurred in elderly males,with the common clinical manifestation of chest pain,usually companied by arrhythmia,and commonly occurred in the antetheca and extensive antetheca.Multivariate analysis results showed that age,history of previous hypertension,history of previous hyperlipidemia,history of previous cardiovascular disease,family history of cardiovascular disease,location of acute myocardial infarction(AMI),and suffering chest pain at disease onset were influencing factors of emergency PCI treatment in patients with STEMI(all P<0.05).Conclusion Patients with STEMI have a lower rate of receiving emergency PCI treatment,and emergency PCI is more likely to be performed in emergency STEMI patients with younger age,AMI occurring in the antetheca,notable chest pain,history of previous hypertension,history of previous hyperlipidemia,history of previous cardiovascular disease,family history of cardiovascular disease,or chest pain arising at the site of AMI or at AMI attack.

关 键 词：急性心肌梗死 ST段抬高型 急诊 经皮冠状动脉介入治疗 影响因素 临床特点 

分 类 号：R542.22[医药卫生—心血管疾病]