急性冠脉综合征院前急救分析及与气象因素的关系  

Analysis on the association of pre-hospital first aid for acute coronary syndrome with meteorological elements

作　　者：邹文蕊 王渝[3] 孙跃民[1] 牛凯军[4] ZOU Wen-rui;WANG Yu;SUN Yue-min;NIU Kai-jun(Department of Cardiovascular,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院心血管内科,天津300052 [2]天津市急救中心急救五科 [3]天津市第三中心医院神经内科 [4]天津医科大学公共卫生学院

出　　处：《中国慢性病预防与控制》2020年第8期591-595,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：天津市自然科学基金重点项目(17JCZDJC34800)。

摘　　要：目的分析院前急性冠脉综合征(ACS)患者的临床特征及气象因素与ACS发病的相关性,为合理安排ACS院前急救策略提供参考。方法连续收集2017年8月至2019年7月天津市急救中心院前诊断为ACS的救治病例,以及天津市气象局提供的同期气象资料。分析院前急救ACS患者的发病年龄构成、月性别差异及临床特征,按月份分析院前急救ACS病例数的变化趋势。应用SPSS 26.0统计软件对数据进行χ^2检验、独立样本t检验、二项分布检验和Spearman秩相关分析。结果院前ACS患者男性平均发病年龄[(63.5±12.8)岁]明显小于女性[(72.2±11.5)岁],差异有统计学意义(P<0.01)。ACS患者性别月分布中男性均多于女性。男性发病高峰年龄段在60~65岁,女性发病高峰年龄段在65~85岁。75岁以前,男性发病例数高于女性;而≥75岁时,女性发病例数明显高于男性,差异有统计学意义(P<0.01)。院前ACS病例中,2、8、9月ST段抬高型ACS和非ST段抬高型ACS发病例数比较,差异有统计学意义(P<0.05)。无论ST段抬高型ACS及非ST段抬高型ACS中,胸痛均是最常见的症状。院前急救ACS患者平均日例数最多为1月(9.45例/d),最少为9月(7.48例/d)。平均相对湿度与ACS发病呈明显的负相关(r=-0.125,P<0.01),日气温差与ACS发病呈明显的正相关(r=0.136,P<0.01),其余气象因素与ACS发病之间无明显的相关性(P>0.05)。结论天津市ACS发病存在明确的性别、年龄差异和月发病差异。平均相对湿度、日气温差与ACS发病相关。院前急救人员应在ACS易发月份和天气做好充分准备,将来对于急性心血管病的防治应考虑气象因素对人体的影响。Objective To investigate the clinical characteristics of patients with acute coronary syndrome(ACS)in patients at prehospital first aid,the correlation between meteorological elements and the incidence of ACS in a pre-hospital setting,and to provide the reference for strategy of pre-hospital first aid of ACS.Methods From August of 2017 to July of 2019,the patients with ACS at pre-hospital first aid in Tianjin’s emergency center were collected,and the data of meteorological elements during the same period from Tianjin Meteorological service were collected.The onset age,monthly sex difference,the clinical characteristics and number change trend of pre-hospital first aid ACS patients were analyzed.Theχ^2 test,t test,binomial distribution test and Spearman rank correlation analysis were used to analyze the data,the used software was SPSS 26.0.Results The mean onset age(63.5±12.8 years old)of pre-hospital first aid ACS patients in males was significantly lower than that(72.2±11.5 years old)in females(P<0.01).The monthly sex number of pre-hospital first aid ACS patients in males was higher than that in females.The peak of onset age in pre-hospital first aid ACS patients of males was 60-65 years old,the peak of onset age in pre-hospital first aid ACS patients of females was 65-85 years old.Before 75 years old,the case number in males was significantly higher than that in females,after≥75 years old,the case number in females was significantly higher than that in males(P<0.01).In pre-hospital ACS patients,there was significant difference of case number between ST segment elevation ACS and non-ST elevation ACS in February,August and September(P<0.01).In both ST segment elevation ACS and non-ST elevation ACS patients,chest pain was the most common symptom.In pre-hospital ACS patients,the mean case number per day(9.45 cases/d)in January was the highest,the mean case per day(7.48 cases/d)in September was the lowest.The daily average relative humidity was negatively correlated to the incidence of ACS(r=-0.125,P<0.01),th

关 键 词：急性冠脉综合征 院前急救 气象因素 

分 类 号：R541.4[医药卫生—心血管疾病] R122.2[医药卫生—内科学]