陈文明,郭金成,柳子静,王国忠,高国旺,张正海,张立新,张海滨

• 1:首都医科大学附属北京潞河医院心内科

摘要(Abstract)：

目的评价首次医疗接触-梗死相关动脉开通(FMC2B)时间达标情况及影响因素。方法回顾性分析2013年7月至2014年9月于首都医科大学附属北京潞河医院行直接经皮冠状动脉介入治疗(PCI)的ST段抬高心肌梗死(STEMI)患者140例,根据《急性ST段抬高型心肌梗死诊断和治疗指南》的FMC2B时间建议,分为FMC2B达标组(59例)和FMC2B未达标组(81例),应用logistic回归分析影响FMC2B达标的因素。结果 140例患者中,首诊到非直接PCI医疗机构转运者58例,直接呼叫急救医疗服务系统到院31例,直接到潞河医院就诊51例。FMC2B中位时间为106.16 min,达标率为42.1%(59/140)。多因素logistic回归分析显示,首诊10 min内完成心电图(OR 5.61,95%CI 1.91~16.88,P=0.002)、常规工作时间就诊(OR 5.11,95%CI 1.88~13.85,P=0.001)、患者高中以上文化程度(OR 4.16,95%CI 1.53~11.34,P=0.005)和发病时意识到心脏问题(OR 2.58,95%CI 1.13~5.91)与FMC2B达标率高有关,转运PCI(OR 0.37,95%CI 0.15~0.92)则与FMC2B达标率低有关。结论 57.9%直接PCI的STEMI患者FMC2B时间没有达到指南建议标准,尤其是转运PCI患者。首诊心电图完成时间、就诊时间、转运PCI和患者的文化程度、发病时意识到心脏问题是FMC2B达标的独立预测因素。

关键词(KeyWords)： 心肌梗死;首次医疗接触;血管成形术;时间;因素

Abstract:

Keywords:

基金项目(Foundation): 通州区卫生发展专项(2011-7071-01);; 首都临床特色应用研究专项课题(Z131107002213073)

作者(Author): 陈文明,郭金成,柳子静,王国忠,高国旺,张正海,张立新,张海滨

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