威海市区ST段抬高型急性心肌梗死患者延误就医回顾性分析

Analysis of the current situation of delayed treatment in patients with ST segment elevation acute myocardial infarction in Weihai urban district

目的分析威海市区ST段抬高型急性心肌梗死（STEAMI）患者院前延迟时间（PHDT），为制定缩短该地区STEAMI患者接受再灌注治疗时间、挽救患者生命的可行方法提供依据。方法回顾性分析2005-2014年威海市立医院收治的1898例STEAMI患者资料，男性1310例，女性588例，年龄25-74岁，平均年龄（61．98±13．19）岁。收集汇总患者年龄、性别及PHDT等信息。分析患者总PHDT情况，将患者按年龄分为25～54岁组、55～64岁组和65～74岁组，比较不同性别和年龄阶段STEAMI患者PHDT。结果1898例STEAMI患者的总体PHDT为178（103～524）min，其中女性患者PHDT长于男性患者[205（105～552）min vs．169（92～508）min]；65～74岁组女性STEAMI患者的PHDT中位数达到216（118～615）min，远大于25-54岁组男性患者132（75～462）min。STEAMI患者在出现症状后1h及2h内到院就诊率低，为10．2％（194／1898）和36．5％（692／1898），尤其65-74岁女性组最低，仅为6．7％。结论2005-2014年威海市区STEAMI患者的PHDT较高。女性尤其是老年女性有更高的延误就医危险性，需针对性加强对该地区女性尤其是老年女性患者的关注，对这类患者采取预防性措施，以提高其生存率，改善患者预后。

Objective To analyze the pre - hospital delay time （PHDT） of the patients with ST elevation acute myocardial infarction （STEAMI） in Weihai City, and to provide the basis for a feasible method to save the lives of STEAMI patients in this region by shortening the time before they reeeived reperfusion therapy. Methods This retrospective analysis collected clinical data of 1898 cases of STEAMI from 2005 to 2014 in Weihai Municipal Hospital. Among them, 1310 cases were male, 588 were female, ageing from 25 to 74 years old, with an average age of （61.98 ± 13.19） y. We collected the patient age, gender and PHDT information. According to age, the patients were divided into 25 - 54 years group, 55 - 64 years group and 65 - 74 years group, to compare the differences of PHDT among different gender and age of patients with STEAMI PHDT. Results The overall PHDT was 178 （ 103 - 524） min; female was longer than male [ 205 （ 105 - 552 ） min vs. 169 （ 92 ± 508 ） min ]. The female （ 65 ± 74 y） reached 216 （ 118 - 615 ） min, which was much greater than the male （ 25 ± 54 y） with 132 （75 - 462） min. The rate of hospital visits was 10. 2% （194/1 898） and 36. 5% （692/1 898） respectively within 1 h and 2 h after symptom onset; the rate of hospital visit in female （65 -74 y）was 6.7%. Conclusion The STEAMI PHDT of Weihai City is high from 2005 to 2014. Women, especially older women have a higher risk of delay in medical treatment. More attention should be paid, and more preventive measures should be adopted to improve survival rate and prognosis.