影响急性心肌梗塞患者院前延迟时间的因素

Factors Associated with Prehospital Delay Time in Patients with Acute Myocardial Infarction

目的：探讨影响急性心肌梗塞（ＡＭＩ）患者院前延迟时问（ＰＤＩ）的相关因素。 方法：收集４６１例 ＡＭＩ患者，剔除４７例资料不全者，将入选 ４１４例分为 ＰＤＴ≤６ｈ组 ２２１例，ＰＤＴ＞６ ｈ组 １９３例。分析包括性别、年龄、高血压史、糖尿病史、高血脂、吸烟史、既往心绞痛史、发病时间、主要症状、ＰＤＴ，入院时心功能、梗塞部位等。 结果；①ＰＤＴ＞６ｈ组较ＰＤＴ≤６ｈ组年龄大、女性患者比例高、糖尿病史者比例高、既往有心绞痛史者多、夜间发病者比例高，２组比均有显著性差异，Ｐ＜０．０５～０．０１。但典型胸痛症状和入院时心功能不全ＰＤＴ＞６ｈ组较 ＰＤＴ≤６ｈ组比率低，组均有显著性差异，Ｐ＜０．０５～０．０１；②多元逻辑回归分析显示年龄、糖尿病史、既往心绞痛病史、发病时间及入院时心功能不全为影响ＰＤＴ的独立相关因素。 结论：年龄、糖尿病史、心绞痛病史、发病时间及入院时心功能不全为影响ＡＭＩ患者ＰＤＴ的独立相关因素。

Objective:To determine the factors ass ociated with prehospital delay time(PDT)in patients with acute myocardial infarction(AMI) Methods:Dat of sex,age,history of hype rtension,diabetes,hypercholesterolemia and smoking,previous angina,symptom onset time,main symptoms,PDT,and heart function on admission were obtained from 461 A MI patients Results:①There were much difference be tween patients with PDT>6h and patients with PDT≤6h in age(64.2±10.9 vs.59.1 ±11.1,p<0.01),rate of female(30.6% vs.21.7%,p<0 .05),diabetes history(17.6% vs. 8.6%,p<0.01),angina his tory(72.5% vs.54.3%,p<0.1),nocturnal attacks(35.8% vs. 1.3%,p<0.01),typical angina(37.8% vs.64.7%,p<0.01)and heart insufficiency(24. 4% vs.33.9%,p<0.05);②Multivariate logistic regression analyses indicated that age(OR 1.40,95% CI 1.19-1.65),diabetes(OR 1.31,95% CI 1.21-1.42),history of angina( OR 1.39,95% CI 1.30-1.48),symptom onset time(OR 1.37,95% CI 1.06-1.54) and heart insufficiency on admission(OR 1.58,95% CI 0.89-2.83)were the independent factors associated with PDT Conclusion:Age,diabetic or angina hist ory,symptom onset time and heart insuffi ciency on admission are the independent factors associated with PDT in patients with AMI.