2007-2018年住院ST段抬高型心肌梗死和非ST段抬高型心肌梗死患者比例及院内死亡率变化趋势

目的　探讨住院ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）构成比及院内死亡率逐年变化趋势。方法　回顾性分析2007年1月1日至2018年12月31日于海军军医大学（第二军医大学）长海医院心血管内科住院治疗且出院诊断为急性心肌梗死（AMI）的4 868例患者资料，通过年度变化百分比法（APC）分析STEMI和NSTEMI构成比和院内死亡率的变化趋势。结果　4 868例AMI患者中STEMI 患者3 064例（62.9%），NSTEMI患者1 804例（37.1%）。NSTEMI的比例在12年内呈上升趋势（APC值为14.0%，P＜0.01），由2007年的15.7%上升至2018年的45.2%；STEMI患者的比例呈下降趋势（APC值为－5.5%，P＜0.01），由2007年的84.3%下降至2018年的54.8%。2007－2018年，AMI院内死亡率呈下降趋势（APC值为－6.6%，P＜0.05），由2007年的7.0%下降至2018年的4.3%；NSTEMI院内死亡率呈下降趋势（APC值为－11.9%，P＜0.05），由2007年的13.9%下降至2018年的1.9%；而STEMI的院内死亡率并无明显变化（APC值为－3.8%，P=0.225）。结论　2007－2018年我院住院AMI患者中，NSTEMI患者比例呈上升趋势。NSTEMI院内死亡率在12年内呈下降趋势，而STEMI的院内死亡率并无明显下降。

Proportion and in-hospital mortality of hospitalized patients with ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction from 2007 to 2018

Objective To investigate the trends of proportion and in-hospital mortality of patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) over the past 12 years. Methods A retrospective analysis was performed on 4 868 patients, who were hospitalized for acute myocardial infarction (AMI) in the Department of Cardiovasology, Changhai Hospital, Naval Medical University (Second Military Medical University) from Jan. 1, 2007 to Dec. 31, 2018. The annual percentage change (APC) method was used to analyze the changes of the proportion and in-hospital mortality of STEMI and NSTEMI patients. Results Of the 4 868 AMI patients, 3 064 (62.9%) had STEMI and 1 804 (37.1%) had NSTEMI. The proportion of NSTEMI patients significantly increased within the 12 years (APC value 14.0%, P<0.01), from 15.7% in 2007 to 45.2% in 2018; the proportion of STEMI patients showed a significant decline (APC value -5.5%, P<0.01), from 84.3% in 2007 to 54.8% in 2018. The in-hospital mortality of AMI patients showed a significantly downward trend (APC value -6.6%, P<0.05), from 7.0% in 2007 to 4.3% in 2018. The in-hospital mortality of NSTEMI patients also showed a significant decline (APC value -11.9%, P<0.05), from 13.9% in 2007 to 1.9% in 2018, while that of STEMI patients showed no significant change (APC value -3.8%, P=0.225). Conclusion Among AMI patients in our hospital from 2007 to 2018, the proportion of NSTEMI patients showed an increasing trend. The in-hospital mortality of NSTEMI patients decreased within the 12 years, while that of STEMI patients did not.