医疗转运对老年急性NSTEMI患者生活质量及心功能的影响  

Influence of medical transfer on quality of life and cardiac function in aged patients with acute NSTEMI

作　　者：杨威[1] 王国栋[1] 李寿霖[1] 陈思远[1] 郑志昌[1] 王晓荣[1] 刘杰[1] 林伟[1] YANG Wei;WANG Guo-dong;LI Shou-lin;CHEN Si-yuan;ZHENG Zhi-chang;WANG Xiao-rong;LIU Jie;LIN Wei(Department of Cardiology,China Rehabilitation Research Center,Beijing,100068,China)

机构地区：[1]中国康复研究中心心内科,北京100068

出　　处：《心血管康复医学杂志》2020年第5期578-582,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:比较不同转运模式下急性非ST段抬高型心肌梗死(NSTEMI)患者临床特点,并分析其对患者的预后影响。方法:回顾性分析本院2015年12月-2018年12月收治的NSTEMI患者的临床资料,包括165例非医疗转运NSTEMI患者(非医疗转运组)和165例同期接受医疗转运的NSTEMI患者(医疗转运组)。比较两组临床资料,入组时和1个月后的LVEF和日常生活能力量表(ADL)评分,1个月后的6min步行距离(6MWD),治疗及预后情况。结果:与非医疗转运组比较,医疗转运组年龄、糖尿病和吸烟比例显著减小,P均=0.001。与入组时比较,1个月后医疗转运组LVEF、两组的ADL评分均显著升高;与非医疗转运组比较,医疗转运组1个月后LVEF[(46.48±9.53)%比(56.21±7.65)%]、ADL评分[(55.67±13.54)分比(79.52±12.37)分]和6MWD[(377.62±41.28)m比(406.18±45.37)m]显著升高,P均=0.001。医疗转运组发病至就诊时间<3h(30.91%比9.09%)及3~12h(44.85%比23.03%)的比例显著高于非医疗转运组,严重心梗并发症发生率(8.48%比21.21%)显著低于非医疗转运组,P均=0.001。结论:医疗转运可以显著缩短NSTEMI患者的发病至就诊时间,改善患者心功能并提高患者生活质量,降低不良事件发生率,改善预后,值得推广。Objective:To compare clinical characteristics between patients with acute non-ST elevation myocardial infarction(NSTEMI)under different transfer mode,and analyze its impact on patient′s prognosis.Methods:Clinical data of NSTEMI patients treated in our hospital from Dec 2015 to Dec 2018 were retrospectively analyzed,including 165 NSTEMI patients undergoing non-medical transfer(non-MT group)and 165 NSTEMI patients undergoing MT simultaneously(MT group).Clinical data,LVEF and score of ability of daily living scale(ADL)at enrollment and after one month,6min walking distance(6MWD)after one month,treatment and prognosis condition were compared between two groups.Results:Compared with non-MT group,there were significant reductions in age,percentages of diabetes mellitus and smoking in MT group,P=0.001 all.Compared with at enrollment,after one month,there were significant rise in LVEF in MT group and ADL score in two groups;compared with non-MT group after one month,there were significant rise in LVEF[(46.48±9.53)%vs.(56.21±7.65)%],ADL score[(55.67±13.54)scores vs.(79.52±12.37)scores]and 6MWD[(377.62±41.28)m vs.(406.18±45.37)m]in MT group,P=0.001 all.Percentages of onset-to-visit time<3h(30.91%vs.9.09%)and 3~12h(44.85%vs.23.03%)in MT group were significantly higher than those of non-MT group,and incidence rate of severe myocardial infraction complications(8.48%vs.21.21%)was significantly lower than that of non-MT group,P=0.001 all.Conclusion:Medical transport can significantly shorten onset-to-visit time,improve cardiac function and quality of life,reduce incidence rate of adverse events and improve prognosis in NSTEMI patients,which is worth extending.

关 键 词：心肌梗死 老年人 预后 

分 类 号：R542.22[医药卫生—心血管疾病]