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[1]李昊,苏斌杰,任莎卡,等.非心脏科住院患者急性ST段抬高型心肌梗死诊疗现状分析[J].国际心血管病杂志,2018,02:89-93.
　LI Hao,SU Binjie,RANSHAKA Auckle,et al.Analysis of diagnosis and treatment in patients with acute ST-elevation myocardial infarction who were hospitalized for noncardiac conditions[J].International Journal of Cardiovascular Disease,2018,02:89-93.
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非心脏科住院患者急性ST段抬高型心肌梗死诊疗现状分析

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2018年02期
页码:
89-93
栏目:
临床研究
出版日期:
2018-03-25

文章信息/Info

Title:
Analysis of diagnosis and treatment in patients with acute ST-elevation myocardial infarction who were hospitalized for noncardiac conditions
作者:
李昊; 苏斌杰; 任莎卡; 谢木金; 李海玲; 徐思玲; 车文良
200072 上海,同济大学附属第十人民医院心内科
Author(s):
LI Hao;  SU Binjie;  RANSHAKA Auckle;  XIE Mujin;  LI Hailing;  XU Siling;  CHE Wenliang.
Department of Cardiology, Tenth People's Hospital of Tongji University, Shanghai 200072, China
关键词:
非心脏科;  急性ST段抬高型心肌梗死;  诊断;  治疗
Keywords:
Non-cardiac conditions;  Acute ST-elevation myocardial infarction;  Diagnosis;  Treatment
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2018.02.007
文献标识码:
-
摘要:
目的:分析非心脏科住院患者急性ST段抬高型心肌梗死(STEMI)的诊疗情况。方法:收集2005年1月至2014年12月在上海市第十人民医院非心脏科室住院期间发生STEMI的患者40例(院内STEMI组),随机选取同时间段院外发生STEMI且收住于心脏科的40例患者(院外STEMI组)作为对照,对两组的诊疗情况进行分析。结果:与院外STEMI组相比,院内STEMI组年龄更大,既往有脑血管意外/短暂性脑缺血发作病史及既往确诊冠状动脉粥样硬化性心脏病(冠心病)的比例更高,住院期间阿司匹林及氯吡格雷的使用率更低,起病至获取心电图的时间、获取心电图至进入心导管室的时间更长,冠状动脉造影(CAG)检查率及经皮冠状动脉介入术(PCI)治疗率更低,住院期间心源性死亡率更高(P均< 0.05)。Logistic回归分析提示,起病至获取心电图的时间、CAG检查率、PCI治疗率为院内STEMI组心源性死亡的独立危险因素。结论:非心脏科发生STEMI的住院患者年龄更大、合并冠心病的危险因素更多,住院期间抗血小板治疗率低,心源性死亡率高。缩短住院患者起病至获取心电图的时间、获取心电图至进入导管室的时间,积极进行PCI治疗可能提高此类患者的生存率。
Abstract:
Objective:To investigate the clinical diagnosis and treatment of acute ST-elevation myocardial infarction(STEMI)in patients hospitalized for non-cardiac conditions.Methods:A retrospective analysis was carried out, with 40 cases of STEMI in hospitalized patients from non-cardiac department between January 2005 and December 2014 selected as observation group, while another 40 cases of patients who were diagnosed as STEMI in emergency or outpatient and admitted in cardiac department selected randomly as the control group in the same period. The two groups were analyzed for diagnosis and treatment.Results:Compared with the control group, the patients in observation group had an older age, a higher proportion of CVA/TIA and prior CAD, a lower proportion of administration of aspirin and clopidogrel, a longer median time to obtain ECG and ECG to angiography time, a lower proportion of CAG and PCI, and a higher cardiogenic mortality in hospital(all P<0.05). Multivariable logistic regression analysis showed that the time delay of ECG and the absence of CAG and PCI were independent risk factors of cardiogenic death in STEMI patients hospitalized for non-cardiac conditions.Conclusions:Older age, more risk factors associated with coronary disease, lower proportion of antiplatelet therapy and higher cardiogenic mortality are involved in STEMI inpatients from non-cardiac department. The survival rate of these patients may be improved by shortening the time of getting ECG and transfering to the catheterization laboratory, and receiving active PCI therapy.

参考文献/References

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备注/Memo

备注/Memo:
基金项目:上海医学引导项目(124119a6900); 上海市卫计委面上项目(201640053)
通信作者:车文良,Email:chewenliang@tongji.edu.cn
更新日期/Last Update: 2018-04-20