老年非ST段抬高型心肌梗死患者心电图复极特征及延误就诊的影响因素

Electrocardiogram Repolarization Characteristics and Influencing Factors of Delayed Treatment in Elderly Patients with Non-ST Segment Elevation Myocardial Infarction

目的 探讨老年非ST段抬高型心肌梗死(NSTEMI)患者心电图复极特征及延误就诊的影响因素。方法 采用便利抽样法,选取2020年5月至2022年12月河南省第二人民医院收治的145例老年NSTEMI患者作为观察组,另随机抽取同期100例冠状动脉供血不足患者作为对照组。患者入院后接受心电图检查,比较不同治疗延误时间、门球时间患者临床资料,通过单因素及多因素logistic回归分析延误就诊的相关影响因素。结果 两组均以ST、T改变为主,差异无统计学意义(P>0.05);观察组ST下降幅度>0.2 mV比率高于对照组(P<0.05)。延误时间>6 h和≤6 h患者的受教育程度、就诊方式、症状间断差异有统计学意义(P<0.05);门球时间>90 min患者谈话时间长于门球时间≤90 min患者(P<0.05)。受教育程度、就诊方式、症状间断是院前治疗延误的相关影响因素(P<0.05);谈话时间是院内治疗延误的相关影响因素(P<0.05)。结论 老年NSTEMI患者心电图缺乏特异性表现,延误就诊主要与受教育程度、就诊方式、症状间断、谈话时间等因素有关。

Objective To explore the characteristics of electrocardiogram repolarization and the influencing factors of delayed treatment in elderly patients with non-ST segment elevation myocardial infarction(NSTEMI).Methods A total of 145 elderly NSTEMI patients admitted to the Second People’s Hospital of Henan Province from May 2020 to December 2022 were selected as the observation group,and another 100 patients with coronary artery insufficiency were randomly selected as the control group during the same period.After admission,the patient underwent an electrocardiogram examination to compare clinical data of patients with different treatment delays and goalkeeping times.The relevant influencing factors of delayed treatment were analyzed through univariate and multivariate logistic regression.Results Both groups showed significant changes in ST and T,with no statistically significant difference(P>0.05).The proportion of ST decrease>0.2 mV in the observation group was higher than that in the control group(P<0.05).There were statistically differences in education level,treatment methods,and symptom discontinuities between patients with a delay time of≤6 hours and>6 hours(P<0.05).Patients with a goal kick time more than 90 minutes had longer conversation time than patients with a goal kick time less than 90 minutes(P<0.05).Education level,treatment methods,and intermittent symptoms are related influencing factors for delayed pre-hospital treatment(P<0.05).Talk time was a related influencing factor for delayed treatment in the hospital(P<0.05).Conclusion The electrocardiogram of elderly NSTEMI patients lacks specific manifestations,and delayed treatment is mainly related to factors such as education level,treatment method,intermittent symptoms,and conversation time.