急性心肌梗死患者院前药物干预及其对预后的影响

The pre-hospital medicines intervene and expected influence in acute myocardial infarction

目的本研究回顾性研究阿司匹林在院前急救急性心梗中的使用情况和院前药物干预对急性心梗预后的影响。方法用统计学方法回顾性研究,阿司匹林在院前急救中的使用情况,以及院前用药对预后的影响。结果阿司匹林在急性心梗院前急救中用药比例较低。年龄因素与是否服用阿司匹林无明显相关性。有急性心梗病史、心电图ST段抬高性心梗、非ST段抬高性心梗、高年资出诊医生等因素均与院前阿司匹林的使用有不同程度相关性,矫正了混杂因素,氧气、硝酸甘油、β受体阻滞剂、阿司匹林、氯吡格雷在院前的使用与患者1年内的死亡率只有阿司匹林有相关性。结论在院前急救心肌梗死中阿司匹林的服药率仅占一半,院前急救中及时准确的诊断对于及时服药是关键,因此我院需要大力发展院前急救队伍,提高急救的诊断、治疗水平。

Objective To asssess of the use of aspirin in the pre-hospital setting in acute myocardial infarction（AMI） and b） To identify whether the use of any of the recommended medications was associated with outcome. Methods All patients with a final diagnosis of AMI, transported by the Emergency Medical Services（120） and admitted to the Bao Gang Hospital, in Jan 2014 Dec 2015, were included. Results 890 patients were included. 51 % received aspirin by the 120. 5 factors related with the use of asprin. After adjusting for confounders among patients, only aspirin of the recommended medications was associated with a reduced risk of death within 1 year. Conclusions half of patients with AMI received pre-hospital aspirin. highlights the lack of accurate diagnosis in the pre-hospital environment.aspirin was independently associated with a reduced risk of death, suggesting that we select the use for pre-hospital AMI.