胸痛中心建设持续改进对急性ST段抬高型心肌梗死抢救时间及心血管不良事件的影响

  目的  分析胸痛中心建设持续改进对急性ST段抬高型心肌梗死(STEMI)患者救治效果和不良事件的影响。  方法  比较2020年11月—2021年8月于温州医科大学附属衢州医院胸痛中心建设持续改进前后收治的186例STEMI患者, 将2020年11月—2021年3月(胸痛中心建设持续改进前)收治的患者作为对照组，2021年4月—2021年8月(胸痛中心建设持续改进后)收治的患者作为观察组，2组患者均为93例。比较2组患者救治时间、主要不良心血管事件发生率及出院后1个月心功能情况。  结果  观察组患者救治时间各项指标均短于对照组，差异有统计学意义(均P＜0.05);观察组主要不良心血管事件发生率为6.6%，低于对照组(16.1%，P＜0.05);出院后1个月，观察组左心射血分数(LVEF)、血浆脑钠肽(BNP)、6 min步行距离分别为(52.45±6.02)%、(50.91±4.23)pg/mL、(422.07±20.59)m，均优于对照组(47.62±5.22)%、(68.77±6.81)pg/mL、(391.41±19.45)m，均P＜0.05]。  结论  胸痛中心建设持续改进不仅能缩短STEMI患者抢救时间，还能减少患者心血管不良事件的发生，改善患者预后，值得临床应用。 

Impact of continuous improvement in the construction of the chest-pain centre on the rescue time of acute ST segment elevated myocardial infarction and cardiovascular adverse events

  Objective  To analyse the effect of continuous improvement in chest-pain centre on the treatment effect and adverse events of acute ST segment elevation myocardial infarction (STEMI).  Methods  A total of 186 patients with STEMI within 12 h before and after the establishment of chest-pain centre of Quzhou Hospital Affiliated to Wenzhou Medical University from November 2020 to August 2021 were compared. Patients treated from November 2020 to March 2021 (before the continuous improvement in chest-pain centre construction) served as the control group. Patients treated from April 2021 to August 2021 (after the continuous improvement in chest-pain centre construction) served as the observation group. There were 93 patients in both groups. Treatment time, incidence of major adverse cardiovascular events, and cardiac function at 1 month after discharge were compared between the two groups.  Results  The treatment time of patients in the observation group was shorter than that in the control group (all P < 0.05). The incidence of major adverse cardiovascular events in the observation group was 6.6%, lower than 16.1% in the control group (P < 0.05). One month after discharge, the left ventricular ejection fraction (LVEF), plasma brain natriuretic peptide (BNP), and 6 min walking distance in the observation group were (52.45±6.02) %, (50.91±4.23) pg/mL, (422.07±20.59) m, respectively, which were better than those in the control group (47.62±5.22) %, (68.77±6.81) pg/mL, (391.41±19.45) m, all P < 0.05].  Conclusion  The continuous improvement in the construction of chest-pain centre can shorten the rescue time of STEMI patients, reduce the occurrence of cardiovascular adverse events, and improve the prognosis of patients, which is worthy of clinical application.