实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (4): 360-363.doi: 10.3969/j.issn.1003-9198.2022.04.009

• 临床研究 • 上一篇    下一篇

建设胸痛中心对老年急性非ST段抬高型心肌梗死病人诊疗进程及近期预后的影响

刘俊荣, 石俊松, 李林   

  1. 236500 安徽省阜阳市,界首市人民医院心血管内科
  • 收稿日期:2021-05-09 出版日期:2022-04-20 发布日期:2022-04-26

Effect of chest pain center on diagnosis and treatment process and short-term prognosis in elderly patients with acute non-ST-segment elevation myocardial infarction

LIU Jun-rong, SHI Jun-song, LI Lin   

  1. Department of Cardiovascular Medicine, Jieshou People′s Hospital, Fuyang 236500, China
  • Received:2021-05-09 Online:2022-04-20 Published:2022-04-26

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摘要： 目的 评价胸痛中心(CPC)建设后对老年急性非ST段抬高型心肌梗死(NSTEMI)病人诊疗进程及近期预后的影响。 方法 将CPC建设前我院急诊救治的33例NSTEMI病人作为对照组,2019年4月CPC建设后救治的37例NSTEMI病人作为观察组,比较2组诊疗进程相关指标,包括急诊双抗治疗时间、首次医疗接触至经皮冠状动脉介入治疗(PCI)时间;同时比较2组院内死亡率及恶性心律失常、心力衰竭等不良心脏事件发生率。PCI治疗后1周LVEF、左室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV),对近期预后进行评价。结果 2组病人来院方式、急诊PCI、择期PCI构成比差异均无统计学意义(P＞0.05)。观察组中危和高危病人急诊双抗治疗时间及高危病人的首次医疗接触至PCI时间均短于对照组,差异均有统计学意义(P＜0.05)。2组病人PCI术后1周LVEDV、LVESV、LVEF差异均无统计学意义(P＞0.05)。观察组病人住院期间心脏不良事件发生率明显低于对照组(10.81% 比27.27%,P＜0.05)。 结论 CPC的建设可缩短NSTEMI病人的诊疗进程,提高病人近期预后。

关键词: 胸痛中心, 急性非ST段抬高型心肌梗死, 诊疗进程, 近期预后

Abstract: Objective To evaluate the effect of the establishment of the chest pain center(CPC) on the diagnosis and treatment process and short-term prognosis in the elderly patients with acute non-ST-elevation myocardial infarction(NSTEMI). Methods A total of 33 patients with NSTEMI who were treated in the Department of Emergency of our hospital before the construction of the CPC were enrolled as the control group, and 37 patients with NSTEMI who were treated after the construction of the CPC in April 2019 were recruited into the observation group. Diagnosis and treatment process related indicators, including time of emergency double antibody treatment, time of first medical contact to percutaneous coronary intervention(PCI), and the hospital mortality, the incidence of malignant arrhythmia, heart failure and other adverse cardiac events in two groups were observed and compared. The levels of left ventricular ejection fraction(LVEF), left ventricular end systolic volume(LVESV) and left ventricular end diastolic volume(LVEDV) before and after treatment in two groups one week after PCI were detected for evaluation of the short-term prognosis. Results There were no significant difference in the constituent ratios of the way of hospital admission, emergency PCI and elective PCI between the two groups(P> 0.05). The duration of emergency dual antiplatelet therapy in the patients with intermediate and high risk, and the duration of first medical exposure-PCI in the patients with high risk in the observation group were shorter than those in the control group(P<0.05). There were no significant difference in the LVEDV, LVESV, and LVEF at 1 week after PCI between the two groups(P> 0.05). The incidence rate of cardiac adverse events in the observation group during hospitalization was significantly lower than that in the control group(10.81% vs 27.27%, P<0.05). Conclusions The establishment of CPC can shorten the diagnosis and treatment process and improve the short-term prognosis in the elderly patients with NSTEMI.

Key words: chest pain center, acute non-ST-segment elevation myocardial infarction, diagnosis and treatment process, recent prognosis

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