摘要
目的探讨性别对ST段抬高型心肌梗塞（STEMI）患者院前延迟时间（PHDT）的影响。方法选择2014年4月至2015年11月明确诊断为STEMI并接受直接经皮冠状动脉介入治疗的患者447例。根据性别分成男性患者组（371例）及女性患者组（76例）,比较两组患者间年龄、糖尿病、高血压、高脂血症、吸烟、冠心病、脑血管疾病、就诊方式、PHDT及医疗保险类型的差异,同时,将PHDT分为5段：0-3 h、〉3-6 h、〉6-12 h,〉12-24 h和〉24 h,建立多元Logistic回归模型评价性别及其他危险因素对不同PHDT的影响。结果女性患者的年龄显著高于男性患者的年龄[（64±8）岁vs.（56±11）岁,t=1.040,P=0.001],且女性患者PHDT亦明显高于男性患者[（396±38）min vs.（367±30）min,t=1.219,P=0.017]。两组患者医疗保险的比较,差异有统计学意义（χ2=5.500,P=0.007）。多元Logistic回归模型分析显示,性别与院前时间延长有关（95%可信区间：0.216-0.981,P=0.049）,同时就诊方式（95%可信区间：0.198-0.711,P=0.003）及保险类型（95%可信区间：0.004-0.587,P=0.018）也与院前时间延长有关。结论女性与STEMI患者PHDT相关。
Objective To investigate the effect of sex factor on pre-hospital delay time （PHI）T） in patients with ST-segment elevation myocardial infarction （STEMI）. Methods A total of 447 patients with STEMI from April 2014 to November 2015 were divided into the male group （371 cases） and female group （76 cases）. The age, diabetes, hypertension, hyperlipemia, smoking history, coronary heart disease, cerebrovascular disease, way of seeking medical care, PHDT and type of medical treatment insurance were recorded and compared. Meanwhile, the PHDT were categorized into five groups： 〈 3 h group, 〉 3 - 6 h group, 〉 6 - 12 h group, 〉 12 - 24 h and 〉 24 h group. Logistics regression model was used to investigate sex and other factors on PHDT in patients with STEMI. Results The age in the female group were much higher than that in the male group [（64 ± 8） vs. （56± 11）, t= 1.040, P= 0.001], and the PHDT in the female group was much longer than that in the male group [（396 ± 38） min vs. （367 ± 30） min, t = 1.219, P= 0.017]. The type of medical treatment insurance also showed singificant differences between the two groups （x2 = 5.500,P= 0.007）. Meanwhile, the muhivariate Logistic regression analysis revealed that the female patients with STEM I （95% confidence interval： 0.216- 0.981, P = 0.049）, way of seeking medical care （95% confidence interval： 0.198-0.711, P= 0.003）, the type of medical treatment insurance （95% confidence interval： 0.004- 0.587, P= 0.018） were associated with PHDT. Conclusion The female sex was associated with PI-/DT in STEM/ patients.
作者
董永伟
陈宇
郑文
贺晓楠
Dong Yongwei Chen Yu Zheng Wen He Xiaonan(Emergency Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China Department of Cardiology, China-Japan United Hospital Affiliated Jilin University, Changchun 130021, China)
出处
《中华危重症医学杂志（电子版）》
CAS
2016年第6期376-379,共4页
Chinese Journal of Critical Care Medicine:Electronic Edition
基金
首都临床特色应用研究专项课题基金项目(Z141107002514014)
关键词
性别因素
心肌梗塞
院前延迟时间
Sex factors
Myocardial infarction
Pre-hospital delay time
