首次医疗接触时间对非ST段抬高型急性心肌梗死患者临床的影响  

Effect of First Medical Contact Time on the Symptom in Patients with Non-ST Elevation Acute Myocardial Infarction

作　　者：王翔 熊小雪 李宾 甘受益 WANG Xiang;XIONG Xiao-xue;LI Bing(Cinical Department,Xianning Central Hospital,Xianning Hubei 437100,China)

机构地区：[1]咸宁市中心医院心血管内科,湖北咸宁437100

出　　处：《湖北科技学院学报（医学版）》2024年第2期137-140,共4页Journal of Hubei University of Science and Technology(Medical Sciences)

基　　金：咸宁市中心医院课题项目(2021XYB001)。

摘　　要：目的探讨在胸痛中心区域协同救治体系下,非ST段抬高型急性心肌梗死(NSTEMI)患者发病至首次医疗接触时间(S-FMC)对患者心功能的影响以及近期预后情况分析。方法采用回顾性分析,分析整理我院标准版胸痛中心数据库,选择时间节点完整的NSTEMI患者共105例。按照S-FMC的长短,分为早期组(0~6h)、中期组(7~24h)、亚中期组(25~72h)和晚期组(>72h)共4个研究组。分析在不同S-FMC下患者住院期间心功能不全以及出院后1个月内心血管不良事件(MACE)发生率。结果4个研究组平均就诊时间是(2.77±1.78)h、(14.34±5.65)h、(43.25±15.16)h和(101.75±17.89)h,住院期间心功能不全发生率分别是26.3%、53.7%、40.0%、81.8%,出院后1个月内发生MACE的概率分别是28.9%、61.1%、70.7%、63.6%,差异均具有统计学意义(P均<0.05)。结论在胸痛中心区域协同救治体系下,对于NSTEMI患者,缩短S-FMC可降低住院期间心功能不全的发生率,减少出院后1个月内MACE的风险。Objective To investigate the effect of the symptom to first medical contact time on heart failure and the recent prognosis of patients with non-ST elevation acute myocardial infarction under the cooperative treatment system of chest pain center.Methods A retrospective analysis was conducted to analyze and compile the chest pain center database of Xian Ning Central Hospital.A total of 105 patients with non-ST elevation acute myocardial infarction(NSTEMI)with complete time nodes were selected.According to the length of the symptom to first medical contact time(S-FMC),the study groups were divided into four groups:early group(0~6h),middle group(7~24h),sub-middle group(25~72h)and late group(>72h).The effects of heart failure in patients and major adverse cardiovascular events(MACE)within one month after discharge were analyzed with different duration of the S-FMC.Results The average treatment time of the four study groups were(2.77±1.78)h,(14.34±5.65)h,(43.25±15.16)h and(101.75±17.89)h,respectively.The incidence of heart failure during hospitalization were 26.3%,53.7%,40.0%and 81.8%.The probability of major adverse cardiovascular events within one month after discharge were 28.9%,61.1%,70.7%and 63.6%.The differences were statistically significant(P<0.05).Conclusion As the patients with NSTEMI,the decreased of S-FMC reduces the incidence of heart failure during hospitalization and the MACE within one month after discharge under the cooperative treatment system of chest pain center.

关 键 词：首次医疗接触时间 胸痛中心 非ST段抬高型急性心肌梗死 心功能不全 心血管不良事件 

分 类 号：R542.2[医药卫生—心血管疾病]