首次医疗接触时间对急性ST段抬高型心肌梗死患者预后的影响

Relationship between first medical contact time and prognosis of patients with acute ST-segment elevation myocardial infarction

目的 探讨首次医疗接触时间对急性ST段抬高型心肌梗死患者预后的影响。方法 选择2016年1月至2017年8月本院收治的急性ST段抬高型心肌梗死患者90例，按照首次医疗接触时间分为两组，各45例，所有入组者都实施急性血管再通治疗，其中观察组为首次医疗接触时间在2 h以内者，对照组则为首次医疗接触时间在2~4 h之间者，比较治疗后1周两组心脏彩超相关参数、心房脑钠肽和纽约心功能分级，统计两组治疗期间出现的并发症。结果 治疗后1周，观察组LVEF高于对照组（P＜0.05），LAD大于对照组（P＜0.05），观察组心房脑钠肽水平低于对照组（P＜0.05），纽约心功能分级优于对照组（P＜0.05）；治疗期间，观察组出现的再发心肌梗死、心力衰竭和心源性死亡比例均低于对照组（均P＜0.05）。结论 加强急性心肌梗死患者对首次医疗接触时间的重视，能改善心肌功能，减少并发症，提高患者预后。

Objective To investigate the relationship between the first medical contact time and the prognosis of patients with acute ST-elevation myocardial infarction.Methods 90 patients with acute ST-segment elevation myocardial infarction admitted into our hospital from January,2016 to August,2017 were divided into an observation group and a control group according to the first medical contact time.All the patients were treated with acute recanalization.The observation group’s first medical contact time was within 2 h and the control group’s 2-4 h.After 1 week’s treatment,the two groups’cardiac color doppler correlation parameters,atrial natriuretic peptide,New York heart functional classification,and complications were compared.Results The LVEF level and the LAD were higher,the level of atrial natriuretic peptide and the incidences of recurrent myocardial infarction,heart failure,and cardiac death during the treatment were lower,and the New York heart functional classification was better in the observation group than in the control group(P<0.05).Conclusion For patients with acute myocardial infarction,the first medical contact time should be paid great attention to,so as to improve the patients’myocardial function and prognosis and reduce the patients’complications.