COVID-19不同时期防控措施对NSTEMI住院患者并发肺部感染的诊断和预后影响

Effects of Covid-19 Prevention and Control Measures in Different Periods on the Diagnosis and Prognosis of NSTEMI Inpatients Complicated with Pulmonary Infection

【目的】分析新型冠状病毒肺炎(COVID-19)不同时期防控措施对非ST段抬高型心肌梗死(NSTEMI)住院患者并发肺部感染的诊断和预后影响。【方法】回顾性分析苏州大学附属第三医院在COVID-19不同防控措施下收治的126例NSTEMI患者,分为非新冠疫情流行组(2019年1月25日至2019年2月25日,非流行组,n=47),新冠疫情一级响应组(2020年1月25日至2020年2月25日,一级响应组,n=42)和新冠疫情常态化防控组(2021年1月25日至2021年2月25日,常态防控组,n=37)。比较三组研究对象的临床特征、肺部感染以及院内病死率,分析疫情防控措施下NSTEMI住院患者并发肺部感染的影响因素。【结果】三组患者就诊时间、卧床时间、心率和心力衰竭比较,差异有统计学意义(P<0.05)。非流行组、一级响应组和常态防控组肺部感染发生率比较差异有统计学意义(P<0.01)。多因素二元Logistic回归分析显示,就诊时间、心力衰竭和卧床时间是NSTEMI患者发生肺部感染的影响因素(均P<0.05)。【结论】COVID-19防控一级响应期间的救治措施提高了NSTEMI患者中肺部感染的诊断率,但未增加NSTEMI并发肺部感染患者院内不良预后。

【Objective】To analyze the diagnosis and prognosis of pulmonary infection in patients with non ST segment elevation myocardial infarction(NSTEMI)at different stages of New Coronavirus pneumonia(COVID-19).【Methods】A retrospective analysis of 126 NSTEMI patients admitted to the Third Affiliated Hospital of Suzhou University under different prevention and control measures of COVID-19 was made into non COVID-19 epidemic group.(January 25,2019 to February 25,2019,non epidemic group,n=47),COVID-19 first responder group(January 25,2020 to February 25,2020,first responder group,n=42)and COVID-19 normal control group.(from January 25,2021 to February 25,2021,normal control group,n=37).The clinical characteristics,pulmonary infection and hospital mortality of the three groups were compared,and the influencing factors of NSTEMI inpatients complicated with pulmonary infection under epidemic prevention and control measures were analyzed.【Results】There were significant differences in visit time,bed time,heart rate and heart failure among the three groups(P<0.05).There was significant difference in the incidence of pulmonary infection among non epidemic group,primary response group and normal prevention and control group(P<0.001).Multivariate binary logistic regression analysis showed that visit time,heart failure and bed time were the influencing factors of pulmonary infection in NSTEMI patients(mean P<0.05).【Conclusion】The treatment measures during the first-class response of covid-19 prevention and control improved the detection rate of pulmonary infection in patients with NSTEMI,and did not increase the adverse prognosis in hospital in patients with NSTEMI complicated with pulmonary infection.