摘要
目的从整个发病时间窗来探究急救时间窗与心室结构的关系,为指导临床提供急救依据。方法选取2017年1月-2019年6月在成都市第二人民医院接受急诊经皮冠状动脉介入手术并住院治疗的急性ST段抬高型心肌梗死患者共253例,根据术后3个月左室舒张末容积增长率是否≥20%分为两组,即重塑组(n=87)和非重塑组(n=166)。比较两组患者的一般临床资料、血清学生化指标及急救时间窗等情况,再通过亚组分析时间窗与心室重塑指标关系。结果相关性分析显示:发病至首次医疗接触(symptom onset to first medical contact,SO-to-FMC)时间、发病至球囊扩张(symptom onset to balloon,STB)时间与左室重塑指标左室舒张末期容积、左室舒张末期容积增长率均呈正相关,SO-to-FMC时间、STB时间是急性ST段抬高型心肌梗死患者发生心室重塑的独立危险因素,差异有统计学意义(rs>0,P<0.05)。结论SO-to-FMC时间、STB时间延长可能促进急性ST段抬高型心肌梗死患者心肌梗死后心室重塑的病理发展,医务工作者需进一步把控好这部分院外急救时间。
Objective To explore the relationship between first aid time window and ventricular structure from the whole onset time window,and to provide first aid basis for guiding clinic.Methods From January 2017 to June 2019,253 patients with STEMI were selected from Chengdu Second People’s Hospital for primary percutaneous coronary intervention.According to whether the growth rate of left ventricular end-diastolic volume(LVEDV)was≥20%at 3 months after operation,these patients were divided into two groups:reconstruction group(n=87)and non-remodeling group(n=166).The general clinical data,serum biochemical indexes and the first aid time window of the two groups were compared,and then the correlation between the first aid time window and ventricular remodeling index in the reconstruction group was analyzed.Results The correlation analysis between the first aid time window and left ventricular remodeling index in remodeling group showed that SO-to-FMC time,STB time and left ventricular remodeling index LVEDV,ΔLVEDV(n)%were positively correlated.SO-to-FMC time and STB time were independent risk factors for ventricular remodeling in patients with STEMI.Conclusion It is considered that the prolongation of symptom onset time(SO-to-FMC time,STB time)may promote the pathological development of ventricular remodeling after myocardial infarction in patients with STEMI.
作者
赵鸿泽
刘剑雄
ZHAO Hongze;LIU Jianxiong(Zunyi Medical University,Zunyi 563003,Guizhou,China;Department of Cardiology,Zunyi Medical University Affiliated Hospital of Chendu,The Sencond People’s Hospital of Chengdu,Chengdu 610017,Sichuan,China)
出处
《心血管病学进展》
CAS
2020年第2期208-213,共6页
Advances in Cardiovascular Diseases
关键词
急性ST段抬高型心肌梗死
急诊冠状动脉介入治疗
急救时间窗
心室重塑
Acute ST-segment elevation myocardial infarction
Primary percutaneous coronary intervention
First aid time window
Ventricular remodeling
