影响急性心肌梗死的血运重建因素分析

The influencing factors of receiving revasclarization in the patients with acute ST-segment elevation myocardial infarction

目的分析兰州大学第一医院近三年来急性ST段抬高心肌梗死(STEMI)患者的治疗现状及影响患者接受经皮冠状动脉介入(PCI)治疗的因素。方法回顾性分析2009年至2011年收治的1016名STEMI患者的临床诊治资料。结果 78.3%的患者发病到入院时间>12小时,其中97.6%未能进行急诊PCI。1016名患者中,17.9%的患者接受了急诊PCI治疗,68.8%的患者接受了择期PCI治疗,11.6%的患者仅接受了药物治疗,溶栓的患者仅占1.6%。年龄、合并糖尿病、职业及发病地点距医院的距离均是影响患者接受急诊PCI治疗的原因。结论患者就诊不及时和转运时间延误是导致STEMI患者不能及时血运重建的主要原因,在时间窗就诊的患者医生的因素是未行血运重建的关键因素。

Objective To evaluate the influencing factor of receiving revascularization in patients with STEMI. Methods A retrospective study,enrolling 1016 patients with STEMI,was carried out to analyse the clinical data including the time from symptoms onset to admission to hospital,etc. Results （1） Most patients （78. 3% ） showed delay in admission to hospital and 97. 6% of theses patients did not receive primary PCI; （2） Among the 1016 patients,17. 9% received primary PCI,68. 8% received elective PCI; 1. 6% received thrombolysis,and 11. 6% received conservative medication. （3） Age,diabetes comorbidity,occupation,availability of nearby hospital were important factors that lead to patients not receiving primary PCI. Conclusions Delay in admission to hospital is the most important reason which caused patients with STEMI could not receive reperfusion in time.