CAJ | 학술논문

目的探讨急诊科预先启动导管室对ST段抬高心肌梗死(STEMI)患者再灌注时间及心肌损伤标志物水平的影响.方法选择2009-01—2010-06成功行急诊PCI的STEMI患者124例.按不同导管室启动模式分为A组54例和B组70例.A组:急诊科医师初步诊断STEMI后通知心内科医师会诊,后者确认后再通过导管室负责人并启动导管室;B组:急诊科医师初步诊断STEMI后直接通知导管室负责人,后者派心内科医师会诊的同时启动导管室.主要分析指标为急诊PCI相关时间:门-球囊(D2B)时间,门-心电图(D2E)时间,心电图-导管室(E2L)时间,导管室-球囊(L2B)时间.次要分析指标:CK-MB、肌钙蛋白I (cTnI)峰值.结果两组临床资料及冠状动脉造影(CAG)结果差异无统计学意义(均P>0.05).与A组相比,B组D2B时间缩短[
목적탐토급진과예선계동도관실대ST단태고심기경사(STEMI)환자재관주시간급심기손상표지물수평적영향.방법선택2009-01—2010-06성공행급진PCI적STEMI환자124례.안불동도관실계동모식분위A조54례화B조70례.A조:급진과의사초보진단STEMI후통지심내과의사회진,후자학인후재통과도관실부책인병계동도관실;B조:급진과의사초보진단STEMI후직접통지도관실부책인,후자파심내과의사회진적동시계동도관실.주요분석지표위급진PCI상관시간:문-구낭(D2B)시간,문-심전도(D2E)시간,심전도-도관실(E2L)시간,도관실-구낭(L2B)시간.차요분석지표:CK-MB、기개단백I (cTnI)봉치.결과량조림상자료급관상동맥조영(CAG)결과차이무통계학의의(균P>0.05).여A조상비,B조D2B시간축단[
Objective To identify the impact of earlier activation of catheterization laboratory on reperfusion time and the serum levels of CK-MB and troponin I of patients with ST-segment elevation myocardial infarction (STEMI). Methods One hun-dred and twenty four consecutive patients with STEMI underwent emergency percutaneous coronary intervention (PCI) from Jan-uary 2009 to June 2010 in Zhejiang Taizhou Hospital. The clinical data were retrospectively analyzed, the activation of catherteri-zation laboratory were impremented by two models:for 54 patients (group A) the catheterization laboratory was activated by car-diologists after consulted the patients and confirmed the digonosis by ECG and for 70 patients (group B) the catheterization lab-oratory was activated by emergency physicians directly. Primary end pionts were door-to-bal oon time (D2B) time, door-to-electrocardiogram (D2E) time, electrocardiogram-to-laboratory(E2L) time and laboratory-to-bal oon (L2B) time;sec-ondary end points included peak of creatine kinase-MB (CK-MB) and Troponin I (TnI). Results The results of CAG and base-line characteristics were similar between the two groups. D2B time in group B were significantly shorter than those in group A (91.3±14.0 vs 103.3±14.1min, P<0.01), which was gained mainly by the shorter of EtoL time (65.4±14.5 vs 75.9±14.5min, P<0.01). Peak CK-MB and TnI in group B were significantly lower than those in group A (257±205 vs 392±292 U/L, P<0.01;43.4±29.5 vs 56.3±32.3 ng/ml, P<0.05). Conclusion Catheterization laboratory activated by emergency department directly can markedly reduce D2B time and decrese the peak of CK-MB and TnI in patients with STEMI .