目的 探讨发病至首次医疗接触(SO-to-FMC)时间与急性ST段抬高型心肌梗死(STEMI)患者预后的关系.方法 选择在郑州人民医院行经皮冠状动脉介入(PCI)治疗的STEMI患者147例,收集病历资料及实验室检查结果,记录患者SO-to-FMC、首次医疗接触至球囊扩张时间(FMC2B)和门诊至球囊扩张(D2B)时间,随访患者出院后死亡和心血管事件的发生情况,依据SO-to-FMC时间将患者分为A组(≤90 min,83例)和B组(>90 min,64例),Logistic回归分析PCI术后心血管相关事件发生的危险因素.结果 A组患者FMC2B时间、D2B时间与B组比较,差异无统计学意义(P>0.05);A组患者心源性死亡率和死亡合计率分别为1.20%和2.41%,均低于B组(7.81%和14.06%),差异有统计学意义,(P<0.05);多因素分析显示SO-to-FMC、FMC2B、D2B和年龄是STEMI患者PCI术后心血管相关事件发生的独立危险因素.结论 SO-to-FMC是急性ST段抬高型心肌梗死患者PCI术后心血管事件发生的独立危险因素,缩短SO-to-FMC对于改善患者预后具有重要意义.
Objective To explore the correlation between symptom onset-to-first medical contact (SO-to-FMC) time and prognosis in patients with acute ST-elevation myocardial infarction (STEMI). Methods 147 patients with STEMI undergoing percutaneous coronary intervention (PCI) were recruited and divided into A group (≤90 min, 64 cases) and B group (>90 min, 64 cases) according to SO-to-FMC time. The medical records and laboratory examination results were recorded. And SO-to-FMC time, medical contact to balloon (FMC2B) time and the clinic to balloon (D2B) time were recorded too. The mortality and cardiovascular events after discharge were followed up. Logistic regression analysis were used to analyze the risk factors for cardiovascular events after PCI. Results There was no significant difference in the FMC2B time and D2B time between A group and B group (both P>0.05). The cardiac mortality and death rate in group A were 1.20% and 2.41%, respectively, which were significantly lower than those in group B (7.81%, 14.06%, both P<0.05). Result of multivariate analysis showed that SO-to-FMC, FMC2B, D2B and age were independent risk factors for cardiovascular events after PCI in STEMI patients. Conclusion SO-to-FMC is an independent risk factor for cardiovascular events after PCI in STEMI patients. Shortening SO-to-FMC is important for improving the prognosis of patients.