急性ST段抬高型心肌梗死质控现状与对策

Quality Control Status and Countermeasures of Acute ST-Segment Elevation Myocardial Infarction

目的了解国内急性ST段抬高型心肌梗死(STEMI)救治现状,提出对策,为急性STEMI质控管理提供参考。方法收集国内公开发表的急性STEMI代表性研究数据,进行描述性分析。结果呼叫120入院比例较低,院前时间延迟突出,基层医院冠状动脉介入治疗比例较低,指南推荐药物血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂应用比例较低,住院死亡率和心力衰竭发生率较高。结论急性STEMI救治在院前时间延迟、再灌注治疗和药物应用方面与指南还存在较大差距。应进一步加大宣传力度,增强公众急救意识,优化基层医院再灌注治疗策略,提高基层医师对急性STEMI重症救治能力等。

Objective To investigate the treatment status of acute ST-segment elevation myocardial infarction(STEMI)in China,and put forward countermeasures to provide reference for STEMI quality control management.Methods The representative data of STEMI published in China were collected for descriptive analysis.Results The hospital admission rate through calling 120 was low,the pre-hospital time was delayed prominently,the proportion of coronary interventional therapy was lower in grass-roots hospital,the proportion of angiotensin-converting enzyme inhibitor/angiotensin receptor antagonist was low,and the incidence of in-hospital mortality and heart failure was high.Conclusion There was still a big gap between the treatment of STEMI and the guidelines in the aspects of pre-hospital delay,reperfusion therapy and drug use.To improve STEMI management,publicity should further strengthen to enhance public awareness of first aid,optimize reperfusion treatment strategies in grass-roots hospital,and improve grass-roots hospital doctors'ability to treat severe STEMI.