CAJ | 학술논문

目的分析比较急性心肌梗死(AMI)患者从就诊到出院的临床特点、院前延误时间(PDT)、就诊及治疗方式等情况.方法设计统一表格,采用调查问卷方式,收集所有AMI患者临床情况.根据发病时间分A组(2004年3月至2005年3月)、B组(2005年3月至2006年3月)和C组(2006年3月至2007年3月),比较三组患者的临床特点、就诊和治疗情况.结果 2004-2007年北京安贞医院心肺血管疾病医疗抢救中心收治1004例AMI患者.3年中急诊收治的AMI患者绝对人数逐年增加,A、B、c三组人数分别为270例、309例和425例,其中≤40岁的AMI患者比例三组分别为4.4%、9.7%和5.9%;既往有脑血管病史分别为8.1%、5.5%和12.8%;既往有冠心病史分别为19.6%、14.3%和31.0%.随着时间的变化,PDT有所改善,三组PDT分别为149、120和130 min;患者选择急救车就诊比例有所增加,三组分别为57.3%、55.7%和64.8%.3年来患者接受急诊经皮冠状动脉介入治疗(PCI)的比例有所增加,三组分别为62.6%、78.0%和74.5%.所有AMI患者总病死率为5.3%,三组分别为5.2%、5.5%和5.2%,病死率无明显变化.结论急诊收治的AMI患者绝对人数呈增加(其中多数患者既往有心脑血管疾病史),≤40岁AMI患者比例亦有增加,接受急诊PCI治疗同样增加,但患者PDT有缩短.
목적 분석비교급성심기경사(AMI)환자종취진도출원적림상특점、원전연오시간(PDT)、취진급치료방식등정황.방법 설계통일표격,채용조사문권방식,수집소유AMI환자림상정황.근거발병시간분A조(2004년3월지2005년3월)、B조(2005년3월지2006년3월)화C조(2006년3월지2007년3월),비교삼조환자적림상특점、취진화치료정황.결과 2004-2007년북경안정의원심폐혈관질병의료창구중심수치1004례AMI환자.3년중급진수치적AMI환자절대인수축년증가,A、B、c삼조인수분별위270례、309례화425례,기중≤40세적AMI환자비례삼조분별위4.4%、9.7%화5.9%;기왕유뇌혈관병사분별위8.1%、5.5%화12.8%;기왕유관심병사분별위19.6%、14.3%화31.0%.수착시간적변화,PDT유소개선,삼조PDT분별위149、120화130 min;환자선택급구차취진비례유소증가,삼조분별위57.3%、55.7%화64.8%.3년래환자접수급진경피관상동맥개입치료(PCI)적비례유소증가,삼조분별위62.6%、78.0%화74.5%.소유AMI환자총병사솔위5.3%,삼조분별위5.2%、5.5%화5.2%,병사솔무명현변화.결론 급진수치적AMI환자절대인수정증가(기중다수환자기왕유심뇌혈관질병사),≤40세AMI환자비례역유증가,접수급진PCI치료동양증가,단환자PDT유축단.
Objective To study the change of baseline clinical characteristics including prehospital delayed time(PDT),modes of transportation and treatment for patients with acute myocardial infarction (AMI)in the past 3 years.Methods We used the same questionnaire to accurately collect and retrospectively analyze the data regarding clinical characteristics of all 1004 patients with AMI,who consecutively presented to the Emergency Unit and Emergency Intensive Care Unit(EICU)of Beijing Anzhen Hospital from March 12th 2004 to March 11th 2007.According to the time of onset of the disease,all patients were divided into 3 groups:group A(from Mar.12th 2004 tO Mar.11th 2005),group B(Mar.12th 2005 to Mar 11th 2006)and group C(Mar.12th 2006 to Mar.11th 2007).Clinieal characteristics and treatment were compared.Results There were significant differences in the number of patients with histories of stroke,coronary artery disease or smoking among the three groups(P＜0.05).No obvious differences in the median of PDT were found among the three groups(P＞0.05).More patients accepted reperfusive therapy in group C compared to group A(P＜0.05),although the mortality rates of AMI among these 3 years were similar.Conclusion Though more people started to have accepted reperfusion therapy,mortality failed to show an obvious decrease.Subject as how tO shorten the PDT called for further study.