溶栓治疗时间对急性ST段抬高型心肌梗死病人住院期间MACE发生率的影响

Effect of the Delay of Thrombolytic Therapy and the Incidence of MACE in Inpatients with ST-segment Elevation Acute Myocardial Infarction

目的探讨溶栓治疗时间的时机对急性ST段抬高型心肌梗死(STEMI)病人住院期间主要不良心脏事件(MACE)发生率的影响。方法选取2013年4月—2016年5月来驻马店市第一人民医院进行溶栓治疗的STEMI病人240例,按照是否溶通将病人分为溶通组(168例)和未溶通组(72例),各组再按照溶栓治疗时间不同分为0 h^5.9 h组、6 h^11.9 h组、≥12 h组,采用多因素Logistic回归模型分析不同溶栓时间对住院期间MACE发生率的影响。结果多因素Logistic回归结果显示,对相关因素进行调整后,无论是否溶通,相对于0 h^5.9 h组,随着溶栓时间的延迟,MACE发生风险均增加(P<0.05)。结论对STEMI病人采取溶栓治疗时,应尽可能在发病6 h内进行,随着溶栓时间的延迟,MACE的发生风险增加。

Objective To investigate the effect of the delay of thrombolytic therapy and the incidence of major adverse cardiac events （MACE） in inpatients with ST elevation acute myocardial infarction （STEMI）.Methods A total of 240 patients underwent thrombo-lytic therapy with STEMI from April 2013 to May 2016 were categorized into recanalization group （n = 168） and non recanalization group （n = 72）,were employed.The patients were stratified in 0 h to 5.9 h,6 h to 11.9 h and 〉 12 h respectively in each group ac-cording to the time receiving thrombolysis therapy.The Multifactor Logistic regression model was performed to investigate the relation-ship between the delay of thrombolytic therapy and the incidence of MACE in patients with STEMI.Results In recanalization group, the risks of MACE adjusted confounding factors in patients receiving thrombolytic therapy in 6 h to 11.9 h and more than 12 h were in-crease which compared with 0 h to 5.9 h group.The same effect was presented in non recanalization group.Conclusion Thrombolytic therapy should be carried out within 6 hours in patients with STEMI,MACE rates were significantly increased in patients with more than 12 hours’ treatment delay.