急性ST段抬高型心肌梗死患者救治与降压达标的相关性研究  

Correlation between the treatment time point and the target to lower blood pressure in patients with acute ST-elevation myocardial infarction

作　　者：刘东霞[1] 高鹏 段亚伟 王燕庆 苏晗琪 LIU Dongxia;GAO Peng;DUAN Yawei(Fifth Department of Cardiac,Hebei General Hospital,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院心内五科,石家庄市050051

出　　处：《河北医药》2023年第17期2616-2619,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20210199)。

摘　　要：目的分析急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)救治时间节点与降压达标的相关性。方法选择CCU于2017年2月至2018年8月收治的行急诊经皮冠状动脉介入术(PCI)的STEMI患者374例,采用统一调查问卷收集资料,根据合并高血压情况分为高血压组168例和非高血压组206例。依据高血压组血压控制达标情况,分为达标组(75例)和未达标组(93例),分析2组间的差异,Logistic回归分析降压达标与首次医疗接解(S-to-FMC)、D-to-B、总缺血时间(TIT)的相关性。结果STEMI患者中高血压患者的检出率44.9%;2、3级高血压患者占92.7%;高血压组与非高血压组比较,2组S-to-FMC、D-to-B、TIT差异无统计学意义(P>0.05);降压达标组S-to-FMC、TIT时间显著低于非达标组(P<0.05)。结论降压达标患者的获益不仅是在降压本身及重要脏器的保护作用,与心血管事件的及时救治有一定的相关性,降压达标的STEMI患者院前延迟时间、心肌总缺血时间缩短,有助于改善患者的预后。Objective To investigate the correlation between the treatment time point and the target to lower blood pressure(BP)in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 374 STEMI patients received emergency percutaneous coronary intervention(PCI)and admitted in the coronary care unit(CCU)from February 2017 to August 2018 were recruited.Their clinical data were collected by the uniform questionnaire survey.Patients were divided into hypertension group(168 subjects)and non-hypertension group(206),according to the presence of hypertension.Hypertension patients were further divided into two groups,namely BP target group(n=75)and non-target group(n=93),according to their BP control condition.Differences between groups were compared.The correlation of the target to BP control with the symptom onset to first medical contact time(S-to-FMC),door-to-balloon time(D-to-B)and total ischemic time(TIT)was identified by Logistic regression analysis.Results The detection rate of hypertension in STEMI patients was 44.9%.The proportion of grade 2 and 3 hypertension in hypertensive STEMI patients was 92.7%.There were no significant differences in the S-to-FMC,D-to-B and TIT between hypertension group and non-hypertension group(P>0.05).S-to-FMC and TIT were significantly shorter in BP target group than those in non-target group(P<0.05).Conclusion The benefits of STEMI patients who reach the target blood pressure not only include the lowering of blood pressure and protection of important organs,but also correlate with cardiovascular events and a timely treatment.An optimal BP control favors to shorten S-to-FMC and TIT in STEMI patients,and improve their prognosis.

关 键 词：急性ST段抬高型心肌梗死 高血压 降压达标 院前延迟 

分 类 号：R542.22[医药卫生—心血管疾病]