论著发病至首次医疗接触时间对急性ST段抬高型心肌梗死患者进门至球囊扩张时间的影响研究

doi:10.7504/nk2014100507

摘要/Abstract

摘要：

目的探讨急性ST段抬高型心肌梗死(STEMI)患者发病至首次医疗接触(SO-to-FMC)时间对进门至球囊扩张(D-to-B)时间的影响。方法回顾性研究2011年8月至2014年9月由救护车送入解放军第306医院，发病12h内接受直接经皮冠状动脉介入治疗(PCI)的STEMI患者149例。记录如下时间：SO-to-FMC、首次医疗接触至进门、D-to-B、发病至球囊扩张。分为SO-to-FMC≤60 min组(82例)和SO-to-FMC＞60 min组(67例)。结果 149例患者SO-to-FMC中位时间(P25，P75)为60(40，105)min；SO-to-FMC≤60 min组D-to-B时间达标率显著高于SO-to-FMC＞60 min组(35.3%对19.4%，P=0.000)，D-to-B时间明显短于SO-to-FMC＞60 min组(中位时间95 min对114 min，P<0.05)，总缺血时间显著短于SO-to-FMC＞60 min组(中位时间179 min对273 min，P<0.05)；两组首次医疗接触至进门时间(中位时间26 min对25 min，P=0.852)差异无统计学意义。结论 SO-to-FMC时间越短即越早寻求医疗干预，D-to-B及总缺血时间也随之越短，因此SO-to-FMC时间可作为STEMI患者急救的新时间指标。

关键词: 心肌梗死, 发病至首次医疗接触, 进门至球囊扩张时间

Abstract:

Abstract：Objective To investigate the impact of symptom onset-first medical contact (Symptom Onset-First Medical Contact，SO-to-FMC) on the door-to-balloon (D-to-B)time in patients with acute ST-segment elevation myocardial infarction (ST elevated myocardial infarction，STEMI).Methods The retrospective study of a single-center；selected 149 STEMI patients sent by ambulance from 2011.08 to 2014.09，and all accept primary percutaneous coronary intervention (percutaneous coronary intervention，PCI) within 12 h after symptom onset.Record the following times：symptom onset-first medical contact，the first medical contact-the door，the door-to-balloon，symptom onset-balloon.Patients were divided into two groups：SO-to-FMC≤60 min group and SO-to-FMC> 60 min groups.Results In the 149 STEMI patients，the median (25%，75%) of SO-to-FMC time was 60 (40，105) min；the standard rate of D-to-B time (D-to-B≤90 min)in SO-to-FMC≤60 min group was significantly higher than SO-to-FMC> 60 min group (35.3% vs 19.4%，P=0.000)；the D-to-B time was shorter than the SO-to-FMC> 60min group (median 95 min vs 114 min，P<0.05);total ischemic time was significantly shorter than SO-to-FMC> 60 min group (median 179 min vs 273 min，P<0.05)；first medical contact-door time of the two groups (median 26 min vs 25 min，P=0.852) was not statistically significant different.Conclusion The shorter of the SO-to-FMC time of patients seek medical intervention earlier，D-to-B and total ischemic time also would be shorter，and therefore SO-to-FMC time could be as a new indicator in the emergency of patients with STEMI.

Key words: myocardial infarction, symptom onset to first medical contact, door to balloon time

中图分类号:

刘佩林，刘莉，赵京涛，宋洪勇，赵蓓，冯雪瑶，刘利峰，刘瑛琪，毛帅，周莉，夏会会，高铁山，王守力. 论著发病至首次医疗接触时间对急性ST段抬高型心肌梗死患者进门至球囊扩张时间的影响研究[J]. 中国实用内科杂志, DOI: 10.7504/nk2014100507.

LIU Pei-lin，LIU Li，ZHAO Jing-tao，SONG Hong-yong，ZHAO Bei，FENG Xue-yao，LIU Li-feng，LIU Ying-qi，MAO Shuai，ZHOU Li，XIA Hui-hui，GAO Tie-shan，WANG Shou-li. Impact of symptom onset-first medical contact on door- to-balloon time in patients with acute ST-segment elevation myocardial infarction[J]. Acta Metallurgica Sinica, DOI: 10.7504/nk2014100507.

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