急性心肌梗死患者院前延迟率及影响因素的Meta分析  

Prehospital delay rate and influencing factors in patients with acute myocardial infarction:a Meta-analysis

作　　者：钟莉 张可 贺志宇 陈灿 王志敏 彭艳红 ZHONG Li;ZHANG Ke;HE Zhiyu;CHEN Can;WANG Zhimin;PENG Yanhong

机构地区：[1]南华大学护理学院,衡阳市421000 [2]南华大学附属第二医院

出　　处：《中华急危重症护理杂志》2025年第2期181-187,共7页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：目的了解急性心肌梗死患者院前延迟率及影响因素。方法计算机检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science数据库中关于急性心肌梗死患者院前延迟率及危险因素的相关文献,检索时限为建库至2024年3月,采用RevMan 5.4和Stata 18.0软件进行Meta分析。结果共纳入20篇文献,包含49041例急性心肌梗死患者,院前延迟2 h发生率为61%(95%CI:53%~69%),院前延迟3 h发生率为58%(95%CI:43%~72%),院前延迟6 h发生率为40%(95%CI:30%~50%)。院前延迟影响因素如下。社会人口学因素:文化程度小学及以下(OR=1.50),年龄≥60岁(OR=1.58),男性(OR=0.68),独居(OR=2.40),居住地农村(OR=2.24);疾病相关因素:糖尿病史(OR=1.54),非典型症状(OR=1.42),冠心病史(OR=1.72);其他因素:入院方式为急救医疗服务(OR=0.49),白天发病(OR=0.62),症状未归因于心脏(OR=4.97)。结论急性心肌梗死患者院前延迟率较高,影响因素涵盖社会人口学、疾病相关因素等多个方面,未来需要进一步的研究来探讨院前延迟与各项影响因素的关系,以有效减少急性心肌梗死患者院前延迟的发生。Objective To conduct a meta-analysis to understand the prehospital delay rate and influencing factors in patients with acute myocardial infarction.Methods Literature related to the prehospital delay rates and risk factors in patients with acute myocardial infarction was retrieved from CNKI,VIP,Wanfang,China Biomedical Literature Database,PubMed,Cochrane Library,Embase,and Web of Science databases.The search time limit was from establishing the database to March 2024.Analysis was performed using Rev Man 5.4 and Stata 18.0.Results A total of 20 articles were included,involving 49041 patients with acute myocardial infarction.The occurrence rates of prehospital delays were 61%(95%CI:53%-69%)at 2 hours,58%(95%CI:43%-72%)at 3 hours,and 40%(95%CI:30%-50%)at 6 hours.Factors influencing prehospital delay included sociodemographic factors included educational level(OR=1.50),age(OR=1.58),gender(OR=0.68),living alone(OR=2.40),and place of residence(OR=2.24);disease-related factors were history of diabetes(OR=1.54),atypical symptoms(OR=1.42),history of coronary heart disease(OR=1.72);and other factors included mode of admission(OR=0.49),onset during the day(OR=0.62),symptom attri-bution(OR=4.97).Conclusion The prehospital delay rate of patients with acute myocardial infarction is high,and factors affecting it cover various aspects such as sociodemographic and disease-related factors.Further research is needed to explore the relationship between influencing factors and prehospital delay to effectively reduce the occurrence of prehospital delay in patients with acute myocardial infarction.

关 键 词：急性心肌梗死 院前延迟 影响因素 META分析 

分 类 号：R473.5[医药卫生—护理学]