De Winter综合征患者的临床特征及院内结局研究  

Clinical Characteristics and In-hospital Outcome of Patients with De Winter Syndrome

作　　者：郝潇[1] 赵美 李树仁[1] 荀丽颖[1] 郝清卿[1] 苑可心[1] 谢悦陶[1] 张倩辉[1] 张飞飞[1] HAO Xiao;ZHAO Mei;LI Shuren;XUN Liying;HAO Qingqing;YUAN Kexin;XIE Yuetao;ZHANG Qianhui;ZHANG Feifei(Department of Cardiovascular Internal Medicine,Hebei General Hospital,Shijiazhuang 050000,China;Ultrasonography Lab,Hebei General Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院心血管内一科,河北省石家庄市050000 [2]河北省人民医院超声科,河北省石家庄市050000

出　　处：《实用心脑肺血管病杂志》2020年第11期101-104,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景近年随着胸痛中心建设的普及,多数胸痛患者能够得到及时救治,但仍有部分胸痛患者因其心电图表现不典型而延误救治。目的分析De Winter综合征患者的临床特征及院内结局,以为其临床诊治和急诊处理提供一定的临床证据。方法连续筛选2018—2019年河北省人民医院心脏中心收治的De Winter综合征患者20例作为观察组,随机选取同期收治的急性前壁心肌梗死患者40例作为对照组。比较两组患者临床资料、实验室检查指标、胸痛救治时间节点、院内治疗及院内结局。结果观察组患者男性占比高于对照组,年龄小于对照组(P<0.05)。观察组患者白细胞计数、中性粒细胞计数大于对照组(P<0.05)。两组患者症状-心电图确诊时间、首诊-心电图确诊时间、症状-肌酸激酶同工酶(CK-MB)峰值时间、门-球时间、心肌总缺血时间比较,差异无统计学意义(P>0.05)。两组患者急诊经皮冠状动脉介入治疗(PCI)率及替格瑞洛、替罗非班、重组人脑利钠肽、依折麦布、β-受体阻滞剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)、螺内酯、呋塞米、依伐布雷定使用率比较,差异无统计学意义(P>0.05)。观察组患者心力衰竭发生率高于对照组(P<0.05)。结论De Winter综合征患者以年轻男性较常见,且院内心力衰竭发生率高于急性前壁心肌梗死者。Background In recent years,with the popularity of the construction of chest pain centers,most chest pain patients can be treated in time,but there are still some chest pain patients whose ECG performance is not typical,delayed treatment.Objective To analyze the clinical characteristics and in-hospital outcome of patients with De Winter syndrome,in order to provide evidence-based medicine for clinical diagnosis and emergency treatment of chest pain.Methods A total of 20 patients with De Winter syndrome in Hebei General Hospital from 2018 to 2019 were selected as observation group,40 patients with acute anterior myocardial infarction were screened as control group.The clinical data,laboratory examination indexes,time points of chest pain treatment,treatment and in-hospital outcome between the two groups were compared.Results The proportion of male in observation group was higher than that in control group,and age in observation group was smaller than that in control group(P<0.05).The WBC and neutrophil count in observation group were higher than those in control group(P<0.05).There was no significant differences in symptoms to ECG diagnosis time,first diagnosis to ECG diagnosis time,symptoms to CK-MB peak value time,goal to ball time and total myocardial ischemia time between the two groups(P>0.05).There was no significant differences in the rate of emergency PCI,usage rate of ticagrelor,tirofiban,recombinant human brain natriuretic peptide,ezetimibe,beta blockers,ACEI/ARB,spironolactone,furosemide,ivabradine between the two groups(P>0.05).The incidence of heart failure in observation group was higher than that in control group(P<0.05).Conclusion Patients with De Winter syndrome are more common in young male,and the incidence of heart failure in hospital is higher than that in patients with acute myocardial infarction.

关 键 词：De Winter综合征 急性前壁心肌梗死 胸痛救治 院内结局 

分 类 号：R542.22[医药卫生—心血管疾病]