胸痛中心建设对行PPCI术的STEMI患者再灌注时间及院内近期预后的影响

摘要

Objective: This study attempt to investigate the impact of construction of Chest Pain Center on reperfusion time and the incidences of heart failure and mortality in-hospital in the patients with ST-segment elevated acute myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). Methods: Totally 658 STEMI patients who underwent PPCI were enrolled. The reperfusion time, incidences of in-hospital heart failure and mortality were compared before and after the establishment of Chest Pain Center. Results: Following the establishment of chest pain center, the door-to-ballon time (D-to-B) was significantly shorten (P<0.05), while first medical contact to ballon time (FMC-to-B) and symptom-to-ballon time(S-to-B) time showed a trend of decline without a statistically significant (P>0.05). The incidences of in-hospital heart failure and mortality showed no significantly difference (P>0.05). Conclusions: Following the construction of our chest pain center, D-to-B time was shortened significantly. However, S-to-B time and FMC-to-B time showed not decreased significantly, and short-term prognosis showed no improvement significantly either. So, to shorten the S-to-B time and to improve the prognosis of the STEMI patients should be the ultimate goals of the construction of chest pain center.%目的：分析胸痛中心建设对行直接PCI术的急性ST段抬高型心肌梗死（ST-segment elevated acute myocardial infarction，STEMI）患者再灌注时间及院内心力衰竭及死亡率的影响。方法：研究纳入658例行直接经皮冠状动脉介入治疗（primary percutaneous coronary intervention，PPCI）的STEMI患者，比较胸痛中心成立前后行PPCI术的STEMI患者再灌注时间及院内心力衰竭和死亡率的变化。结果：医院胸痛中心成立后，行PPCI术的STEMI患者门-球（door-to-ballon，D-to-B）时间显著缩短（P＜0.05），首次医疗接触到球囊扩张（first medical contact to ballon，FMC-to-B）时间及发病到球囊扩张（symptom-to-ballon，S-to-B）时间均呈缩短趋势但未达到显著统计学意义（P＞0.05），院内心力衰竭及死亡率无显著差异（P＞0.05）。结论：胸痛中心成立显著缩短STEMI患者D-to-B时间，但尚未能明显缩短S-to-B和FMC-to-B时间及改善院内近期预后。胸痛中心应以缩短S-to-B时间，改善STEMI患者预后为终极目标。