| 刘 喆,唐 强,谢立强,汪 勇,黄 峰.急性ST段抬高型心肌梗死患者直接介入治疗门-囊时间及影响因素探讨[J].,2017,17(26):5091-5095 |
| 急性ST段抬高型心肌梗死患者直接介入治疗门-囊时间及影响因素探讨 |
| Influencing Factors of Door-to-Balloon Time for Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction |
| 投稿时间：2016-12-27 修订日期：2017-01-16 |
| DOI：10.13241/j.cnki.pmb.2017.26.019 |
| 中文关键词: 心肌梗死 经皮冠状动脉 介入治疗 门-囊时间 |
| 英文关键词: Myocardial infarction Percutaneous coronary artery Interventional therapy The door-to-balloon time |
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| 中文摘要: |
| 摘要 目的：探讨在急性ST段抬高型心肌梗死（STEMI）患者中采用直接经皮冠状动脉介入治疗（PCI）方案所用的门-囊（D2B）时间及其影响因素。方法：选取2014年1月至2016年4月我院收治的行PCI术治疗的180例STEMI患者为研究对象，经患者同意行介入治疗。记录患者院前延迟时间和D2B时间。通过问卷调查患者的人口统计学资料、临床因素、疾病发生的背景及心理因素等相关资料。以D2B时间≤126 min为短D2B组（n=96），>126 min为长D2B组（n=84），采用单因素与多因素logistic回归方法分析D2B时间的影响因素。结果：所有患者D2B时间的中位数为126 min，仅有26.7%的患者D2B时间控制在90 min以内；单因素分析显示，两组患者的突然发作、重视症状、发病时有人在场、症状进展快、节假日住院、入CCU时无症状、门诊就医、应用急救医疗服务体系（EMSS）转运、入CCU时间（6 am-10 pm）、梗前心绞痛及院前延误时间比较，差异有统计学意义（P<0.05）；多因素logistic回归分析结果显示，节假日住院、门诊就医、入CCU无症状、重视症状、应用EMSS转运、入CCU时间（6 am-10 pm）等均为D2B时间的影响因素（OR=2.62，2.04，1.59，0.52，0.28，0.61，P<0.05）。结论：多数STEMI患者的D2B时间均未达到指南要求，患者、医生、院内接诊机制等因素均与D2B时间有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the door-to-balloon (D2B) time and its influencing factors for Percutaneous Coronary Intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: 180 cases of patients with STEMI in our hospital from January 2014 to April 2016 were selected. PCI therapy were operated on all patients after their consent.The pre-hospital delay time and D2B time of the patients were recorded. The related information of the patients, including demographic data, clinical factors, background of the disease and psychological factors, were investigated by the questionnaire survey. The patients were divided into short D2B group (D2B time≤126 min, n=96) and long D2B group (D2B time>126 min, n=84). Univariate and multivariate logistic regression methods were used to analyze the influencing factors of D2B time. Results: The median D2B time of all the patients was 126 min, and only 26.7% of patients' D2B time controlled within 90 min. Univariate analysis showed that differences of sudden attack, pay attention to symptoms,someone was present when attack, symptoms progress was fast, in hospital during holiday, no symptom in CCU, outpatient treatment, transfered by emergency medical service system (EMSS), time in CCU (6 am-10 pm), angina before infarction and pre-hospital delay time between the two groups were statistically significant (P<0.05). Multivariate logistic regression analysis showed that in hospital during holiday, outpatient service, no symptom in CCU, pay attention to symptoms, use of transfered by EMSS, time in CCU (6am-10pm) are the factors affecting the time of D2B (OR=2.62, 2.04, 1.59, 0.52, 0.28, 0.61 P<0.05). Conclusion: The D2B time of most patients with STEMI can not reach the guidelines. The factors of patients, doctors, accepting mechanism of hospital are all related with D2B time. |
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