广西地区急性心肌梗死患者入门-球囊扩张时间延迟原因分析
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摘要
目的分析广西地区急性心肌梗死(AMI)患者入门-球囊扩张时间(D2B)延迟原因。方法 167例广西地区AMI患者,其中D2B>90 min者37例、≤90 min者130例,采用t检验或χ2检验对两者一般资料进行单因素分析,采用logistic回归分析AMI患者D2B延误的影响因素。结果单因素分析结果显示,与D2B≤90 min者相比,D2B>90 min者典型临床症状例数少、非ST段抬高型急性心肌梗死例数多、肌钙蛋白T阳性例数少、典型心电图例数少、心电图-呼叫会诊时间长、会诊-术前谈话时间长(P均<0.05)。logistic回归分析结果显示,AMI类型(OR=0.060,95%CI:0.004~0.891,P<0.05)、心电图-呼叫会诊时间(OR=0.801,95%CI:0.693~0.972,P<0.01)为AMI患者D2B延误的独立影响因素。结论 AMI类型为非ST段抬高型心肌梗死、心电图-呼叫会诊时间长是广西地区AMI患者D2B延迟的原因。
Objective To analyze factors influencing the length of time required for completing whole course of doorto-balloom( D2B) in patients with acute myocardial infarction( AMI) in Guangxi area. Methods One hundred and sixtyseven AMI patients including 37 cases with D2 B > 90 min( D2 B > 90 min group) and 130 cases with D2B≤90 min( D2B≤90 min group) were selected. Their general clinical data were analyzed with univariate analysis. Logistic regression was used to analyze the influencing factors of D2 B delay in AMI patients. Results The univariate analysis showed that compared with D2B≤90 min group,D2 B > 90 min group had less patients with chest pain,more patients with non-ST segment elevated myocardial infarction,less patients with Troponin T positive,fewer typical ECG,longer ECG-call consultation time,and longer consultation and preoperative talk time( all P < 0. 05). Logistic regression showed that AMI types( OR =0. 060,95% CI: 0. 004-0. 891,P < 0. 05) and ECG-call consultation time( OR = 0. 801,95% CI: 0. 693-0. 972,P <0. 01) were independent risk factors for D2 B delay in AMI patients. Conclusion AMI types with non-ST segment elevated myocardial infarction and the long time for the first electrocardiogram to call consultation delay D2 B significantly in AMI patients of Guangxi area.
Objective To analyze factors influencing the length of time required for completing whole course of doorto-balloom( D2B) in patients with acute myocardial infarction( AMI) in Guangxi area. Methods One hundred and sixtyseven AMI patients including 37 cases with D2 B > 90 min( D2 B > 90 min group) and 130 cases with D2B≤90 min( D2B≤90 min group) were selected. Their general clinical data were analyzed with univariate analysis. Logistic regression was used to analyze the influencing factors of D2 B delay in AMI patients. Results The univariate analysis showed that compared with D2B≤90 min group,D2 B > 90 min group had less patients with chest pain,more patients with non-ST segment elevated myocardial infarction,less patients with Troponin T positive,fewer typical ECG,longer ECG-call consultation time,and longer consultation and preoperative talk time( all P < 0. 05). Logistic regression showed that AMI types( OR =0. 060,95% CI: 0. 004-0. 891,P < 0. 05) and ECG-call consultation time( OR = 0. 801,95% CI: 0. 693-0. 972,P <0. 01) were independent risk factors for D2 B delay in AMI patients. Conclusion AMI types with non-ST segment elevated myocardial infarction and the long time for the first electrocardiogram to call consultation delay D2 B significantly in AMI patients of Guangxi area.
引文
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[11]刘辉,张燕,张少利,等.老年非ST段抬高型急性心肌梗死患者临床特征及预后影响因素[J].山东医药,2016,56(11):41-43.
[2]Jhawar M,Chan A,Christianson L,et al.Utilization of phaseⅡcardiac rehabilitation in veterans administration patients[J].Mo Med,2013,110(1):71-73.
[3]Nakamura M,Yamagishi M,Ueno T,et al.Current treatment of ST elevation acute myocardial infarction in Japan:door-to-balloon time and total ischemic time from the J-AMI registry[J].Cardiovasc Interv Ther,2013,28(1):30-36.
[4]Krumholz HM,Herrin J,Miller LE,et al.Improvements in doorto-balloon time in the United States,2005 to 2010[J].Circulation,2011,124(9):1038-1045.
[5]陈灏珠,林果为,王吉耀.实用内科学[M].13版.北京:人民卫生出版社,2013:1409-1480.
[6]赵明中,胡大一,许玉韵.急性心肌梗死患者治疗时间延误因素分析[J].中华全科医师杂志,2002,1(2):81-84.
[7]赵晓静,李贵华,李瑞杰,等.急性心肌梗死院前延迟的研究进展[J].心血管病学进展,2010,2(31):251-253.
[8]张勇,王燕妮.急性ST段抬高型心肌梗死患者治疗延误的影响因素分析[J].西安交通大学学报(医学版),2013,34(3):413-415.
[9]叶少玲,王智明,谢衬梨,等.急性冠状动脉综合征患者延误诊治相关因素分析[J].广州医学院学报,2005,33(4):30-31.
[10]霍勇,陈明.急性ST段抬高心肌梗死介入治疗策略的评价[J].中华内科杂志,2006,45(9):784-785.
[11]刘辉,张燕,张少利,等.老年非ST段抬高型急性心肌梗死患者临床特征及预后影响因素[J].山东医药,2016,56(11):41-43.