ST段抬高型心肌梗死患者总缺血时间的影响因素分析

常慧艳; 乔青; 张荣林

doi:10.13201/j.issn.1001-1439.2015.05.012

ST段抬高型心肌梗死患者总缺血时间的影响因素分析

- 南京医科大学附属鼓楼医院心内科(南京, 210008)

详细信息

作者简介:
张荣林,E-mail:zhangronglin2004@hotmail.com

中图分类号: 541541.4

收稿日期: 2014-10-17

Total ischemic time in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, 210008, China

Received Date: 17 October 2014

摘要

摘要: 目的:本文主要探讨接受急诊冠状动脉介入治疗的ST段抬高型心肌梗死(STEMI)患者总缺血时间的独立影响因素。方法:回顾性分析2009-01-2012-12两家三级医院行急诊介入治疗的STEMI患者资料,评估总缺血时间(TIT)的分布时间段及独立影响因素。结果:两家医院共计有446例患者入选,总缺血时间的25、50、75百分位数分别为203.00、288.50和430.75min,医保、转诊、男性、糖尿病史和不典型胸痛、症状发作到首诊医院就诊时间(SDT)、门-球囊时间(DBT)在不同TIT组间差异有统计学意义(均P<0.01)。多元线性回归分析显示,医保(β:-0.616,P=0.000)、男性(β:-0.414,P=0.001)和转运(β:0.483,P=0.000)是TIT的独立影响因素。结论:自费、转诊和性别是STEMI患者TIT的独立影响因素。
- 急性心肌梗死 /
- 总缺血时间 /
- 危险因素
Abstract: Objective:To explore independent influencing factors of total ischemic time in primary percutaneous coronary intervention.Method:We performed a key process analysis of our 2tertiary-care healthcare ST-elevation myocardial infarction systems.Patients were divided into four groups according to the quartiles of total ischemic time.Patients' demographic information,clinical information,total ischemic time and its components were compared among the four groups.Multi-variable linear regression analysis was employed to reveal the independent infuencing factors.Result:There were 446 patients included.The first,second and third cut-point of total ischemic time was 203.00,288.50 and 430.75 minutes.There was difference in medical insurance status,transferring from another hospital,male,diabetes,atypical chest pain,pain onset to door time,door to balloon time and total ischemic time among the four groups.Noteworthily,some variables were independently correlated with total ischemic time in the study's regression model:medical insurance coverage(β:-0.616,P=0.000),male(β:-0.414,P=0.001) and transfer delay(β:0.483,P=0.000).Conclusion:In this contemporary cohort of patients with STEMI,risk factors associate with total ischemic time are non-medical insurance coverage,transfer delays and gender.
- myocardial infarction /
- total ischemic time /
- risk factors

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