摘要
目的观察分析胸痛中心(chest pain center,CPC)建设对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者再灌注治疗的效果及短期预后。方法选取CPC建设前后因急性胸痛就诊且诊断为STEMI行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)治疗患者284例为研究对象,根据CPC建设时间分为CPC建设前的对照组136例和CPC建设后的观察组148例。分析2组一般资料、主要时间节点差异、治疗后心功能指标差异及术后住院期间心功能不良时间发生率。结果观察组发病至首次医疗接触时间(symptom-to-first medical contact,S2FMC)、首次医疗接触至首份心电图时间(first medical contact to first electrocardiogram,FMC2ECG)、入门至球囊扩张时间(door-to-ballon,D2B)及首次医疗接触至球囊扩张时间(first medical contact-to-balloon,FMC2B)均短于对照组(P<0.05),观察组术后左心室射血分数(left ventricular ejection fraction,LVEF)高于对照组,术后脑钠肽(brain natriuretic peptide,BNP)低于对照组(P<0.05),观察组急性心力衰竭、恶性心律失常、病死率均低于对照组(P<0.05)。结论CPC建设能够有效缩短STEMI患者发病至再灌注的时间,减少了心肌缺血时间,对患者术后心功能的恢复有显著效果,同时降低了术后短期心功能相关不良事件的发生,降低了STEMI患者的病死率,临床应用价值相对更高。
Objective To observe and analyze the effect and short-term prognosis of chest pain center(CPC)construction on reperfusion therapy for patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 284 patients who were treated with percutaneous coronary intervention(PCI)due to acute chest pain and diagnosed as STEMI before and after CPC construction were selected as the research subjects.According to the time of CPC construction,they were divided into the control group(before CPC construction,n=136)and the observation group(after CPC construction,n=148).The general data,differences in major time points,differences in cardiac function indicators after treatment,and the incidence of cardiac dysfunction during postoperative hospitalization between the two groups were analyzed.Results The observation group had shorter symptom onset to first medical contact(S2FMC),first medical contact to first electrocardiogram(FMC2ECG),door to balloon dilation(D2B),and first medical contact to balloon dilation(FMC2B)as compared with the control group(P<0.05).The left ventricular ejection fraction(LVEF)after operation in the observation group was higher than that in the control group,while the brain natriuretic peptide(BNP)was lower than that in the control group(P<0.05).Conclusion CPC construction can effectively shorten the time from onset to reperfusion in STEMI patients,reduce the time of myocardial ischemia,have a significant effect on the recovery of postoperative cardiac function,reduce the occurrence of short-term postoperative cardiac function-related adverse events,and decrease mortality in STEMI patients,showing a relatively higher clinical application value.
作者
徐进林
肖兵
韩从华
朱冬梅
印章
艾宇
XU Jin-lin;XIAO Bing;HAN Cong-hua;ZHU Dong-mei;YIN Zhang;AI Yu(Department of Cardiovascular Medicine,the First People's Hospital of Xiantao City Affiliated to Yangtze University,Hubei Province,Xiantao 433000,China)
出处
《河北医科大学学报》
CAS
2023年第9期1022-1026,共5页
Journal of Hebei Medical University
基金
湖北省卫生健康委员会科研基金(WJ2021F099)。
关键词
ST段抬高型心肌梗死
胸痛中心
经皮冠状动脉介入
T-segment elevation myocardial infarction
chest pain center
percutaneous coronary intervention
