三峡库区农村老年急性心肌梗死患者发病至首次医疗接触时间研究分析

Study on symptom onset-to-first medical contact in patients with acute ST-segment elevation myocardial infarction in rural area of Three Gorges reservoir area

目的探讨发病至首次医疗接触(SO-to-FMC)时间对三峡库区农村地区急性ST段抬高型心肌梗死(STEMI)老年患者预后的影响。方法将87例STEMI患者根据SO-to-FMC时间分为SO-to-FMC≤6 h组(n=48)和SO-to-FMC> 6 h组(n=39)。比较2组患者生存率、左室射血分数(LVEF)、6 min步行试验(6MWD)及纽约心脏病协会(NYHA)分级结果。结果SO-to-FMC≤6 h组生存率为97.9%,高于SO-to-FMC> 6 h组的87.2%,差异有统计学意义(P=0.04)。SO-to-FMC≤6 h组患者6MWD为(376.8±115.8) m,长于SO-to-FMC>6 h组的(318.3±110.8) m,差异有统计学意义(P <0.05)。SO-to-FMC≤6 h组患者LVEF为(57.2±7.2)%,与SO-to-FMC>6 h组的(54.5±6.6)%比较,差异无统计学意义(P>0.05)。SO-to-FMC≤6 h组患者NYHA心功能分级评估结果优于SO-to-FMC> 6 h组,差异有统计学意义(P <0.05)。结论缩短STEMI患者SO-to-FMC时间可以有效提高患者生存率,改善患者预后。

Objective To investigate the influence of symptom onset-to-first medical contact(SO-to-FMC)time on prognosis of elderly patients with acute ST-segment elevation myocardial infarction(STEMI)in rural areas of Three Gorges reservoir area.Methods Eighty seven patients with STEMI were divided into SO-to-FMC≤6 h group(n=48)and SO-to-FMC>6 h group(n=39).The survival rate,left ventricular ejection fraction(LVEF),results of 6-minute walking test(6 MWD)and New York Heart Association(NYHA)classification were compared between the two groups.Results The survival rate of the SO-to-FMC≤6 h group was 97.9%,which was significantly higher than 87.2%of the SO-to-FMC>6 h group(P=0.04).The 6 MWD of the SO-to-FMC≤6 h group was(376.8±115.8)meters,which was significantly longer than(318.3±110.8)meters in the SO-to-FMC>6 h group(P<0.05).The LVEF of the SO-to-FMC≤6 h group was(57.2±7.2)%,which showed no significant difference when compared to(54.5±6.6)%of the SO-to-FMC>6 h group(P>0.05).The result of NYHA cardiac function classification in the SO-to-FMC≤6 h group was significantly better than that in the SO-to-FMC>6 h group(P<0.05).Conclusion Shortening the SO-to-FMC time can effectively improve the survival rate and prognosis of STEMI patients.