门急诊疑似急性心肌梗死患者临床流行病学研究  

Clinical epidemiological study on suspected acute myocardial infarction patients in outpatient and emergency department

作　　者：张胜 孙世坤[2] 袁嘉敏 祁松楠 刘璐[3] 韩清珍[1] 郁佳佳[1] 张丽[1] 董菁[1] 刘冬梅[1] ZHANG Sheng;SUN Shi-kun;YUAN Jia-min(Center for Clinical Laboratory,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院临床检测中心,江苏苏州215006 [2]苏州大学附属第一医院心内科 [3]苏州大学附属第一医院急诊科

出　　处：《中华全科医学》2019年第12期2107-2110,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金青年科学基金项目(81700297)

摘　　要：目的调研苏州地区门急诊疑似急性心肌梗死(AMI)患者临床就诊情况,为今后该病防治提供可靠的临床流行病学理论依据。方法选取2018年度苏州大学附属第一医院门急诊疑似急性心肌梗死就诊患者为研究对象,以Excel建库并运用SPSS统计学软件回顾性分析疑似患者临床资料与高敏肌钙蛋白T(hs-cTnT)检测结果,进一步明确临床人口分布特点、就诊高峰时间段及hs-cTnT检测临床应用价值等特点。结果共纳入门急诊就诊患者13709例,主要因自感胸痛、胸闷、心悸、呼吸困难等不适而就诊,检出疑似AMI患者3585例(26.15%),其中男性2170例(60.53%),女性1415例(39.47%),男女比例为1.5∶1。年龄从11~100岁不等,中位年龄为72岁,各年龄段人群检出差异有统计学意义(P<0.05),其中青少年人群(≤40岁279例,占7.78%),该组间检出无统计学差异(均P>0.05);在中老年人群[≥41岁3306例(92.22%),特别是≥61岁2757例(76.90%)],该组间检出差异有统计学意义(均P<0.05)。季节性检出差异有统计学意义(P<0.05),主要集中于冬季(尤其1~2月)及春季(3~5月),且男性整体检出率始终高于女性患者。患者hs-cTnT水平随年龄增长而不断增高,且同一年龄段男性患者群高于女性,男性患者(≥51岁起)及女性人群(≥61岁起)hs-cTnT检测线高于整体人群基线水平。结论我院门急诊疑似AMI检出率较高,以40岁以上中老年人群为主,应加强胸痛、心悸等自觉症状高危人群hs-cTnT季节性筛查力度和范围。Objective To investigate the clinical treatment of suspected acute myocardial infarction(AMI)patients in outpatient and emergency departments in Suzhou area,and provide reliable clinical epidemiological theoretical basis for the prevention and treatment of AMI in the future.Methods The suspected AMI patients of the first affiliated hospital of Soochow university in 2018 year were selected as the research object.The clinical data of patients and the detection results of high-sensitivity troponin T(hs-cTnT)were analyzed retrospectively by using Excel database and SPSS statistical software,so as to further clarify the characteristics of clinical population distribution,the peak period of treatment and the clinical application value of hs-cTnT.Results A total of 13709 patients were admitted to the outpatient and emergency department for treatment mainly due to self-induced chest pain,chest tightness,palpitations,dyspnea and other discomfort.A total of 3585 cases(26.15%)with suspected AMI were detected,including 2170(60.53%)males and 1415(39.47%)females.The ratio of male to female was 1.5∶1.The age ranged from 11 to 100 years old,and the median age was 72 years old,and there were significant differences among all age groups(all P<0.05).Among them,279(7.78%)cases were young people(<40 years old).In the 3306(92.22%)middle-aged and elderly(>41 years old)cases,especially 2757(76.90%)>61 years old cases,there was statistically significant(P<0.05).The seasonal detection was statistically significant(P<0.05),mainly in winter(especially 1-2 months)and spring(3-5 months).The overall detection rate of male patients was always higher than that of female patients.The hs-cTnT level of the patients increased with age,and the level of male patients in the same age group was higher than that of female patients,and the hs-cTnT detection line of male patients(≥51 years old)and female patients(≥61 years old)was higher than the baseline level of the overall population.Conclusion The detection rate of suspected AMI in our hospital i

关 键 词：急性心肌梗死 高敏肌钙蛋白T 临床流行病学 急诊患者 

分 类 号：R541.4[医药卫生—心血管疾病] R181.32[医药卫生—内科学]