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目的:本文主要探讨接受急诊冠状动脉介入治疗的ST段抬高型心肌梗死(STEMI)患者总缺血时间的独立影响因素。方法:回顾性分析2009-01-2012-12两家三级医院行急诊介入治疗的STEMI患者资料,评估总缺血时间(TIT)的分布时间段及独立影响因素。结果:两家医院共计有446例患者入选,总缺血时间的25、50、75百分位数分别为203.00、288.50和430.75min,医保、转诊、男性、糖尿病史和不典型胸痛、症状发作到首诊医院就诊时间(SDT)、门-球囊时间(DBT)在不同TIT组间差异有统计学意义(均P<0.01)。多元线性回归分析显示,医保(β:-0.616,P=0.000)、男性(β:-0.414,P=0.001)和转运(β:0.483,P=0.000)是TIT的独立影响因素。结论:自费、转诊和性别是STEMI患者TIT的独立影响因素。
OBJECTIVE: This study aimed to investigate the independent influence of total ischemic time on patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI. Methods: The data of STEMI patients undergoing emergency intervention in two tertiary hospitals from January 2009 to December 2012 were retrospectively analyzed to assess the distribution time period and independent influencing factors of total ischemic time (TIT). RESULTS: A total of 446 patients were enrolled in both hospitals. The 25,50 and 75th percentiles of total ischemic time were 203.00, 288.50 and 430.75 min, respectively. Medicare, referral, male, history of diabetes and atypical chest pain, symptoms The onset time to visit the first hospital (SDT), gate-balloon time (DBT) in different TIT group differences were statistically significant (P <0.01). Multivariate linear regression analysis showed that the independent factors of TIT were the health insurance (β: -0.616, P = 0.000), male (β: -0.414, P = 0.001) and transfusion (β: 0.483, P = 0.000). CONCLUSIONS: At-grade, referral and gender were independent predictors of TIT in STEMI patients.