经皮冠状动脉介入治疗184例ST段抬高性急性心肌梗死患者临床特征分析

目的分析基层医院胸痛中心经急诊绿色通道行经皮冠状动脉介入(PCI)治疗ST段抬高性急性心肌梗死(STEMI)患者的临床特征。 方法回顾性分析2017年5月至2019年4月在江苏大学附属武进医院(徐州医科大学武进临床学院)胸痛中心收治的184例行急诊PCI治疗的STEMI患者的临床资料,其中男性147例,女性37例;年龄27～95岁,平均(63.08±13.16)岁。按年龄分为中青年组(<60岁)和老年组(≥60岁),按性别分为男性和女性,比较组间的临床资料,发病时间、门球(D-to-B)时间、血管病变支数、植入支架数以及住院期间主要心血管事件(MACE)等手术治疗参数的差异。 结果男性组患者的年龄及高密度脂蛋白胆固醇(HDL-C)水平低于女性组;而吸烟、饮酒占比及体重指数(BMI)、白细胞(WBC)、血红蛋白(HGB)、尿酸(UA)、肌酐(Cr)水平高于女性组,差异有统计学意义(P<0.05)。与中青年组相比,老年组患者的男性、吸烟、高脂血症占比、BMI、DBP、WBC、HGB、PLT和TG水平较低,而高血压占比高、HDL-C和全球急性冠状动脉事件注册评分(GRACE)较高,差异有统计学意义(P<0.05);老年组患者的血管病变支数多于中青年组[2(1～3)个比1(1～2)个,U＝ 3.24,P<0.05];但住院期间MACE事件发生例次的差异无统计学意义(P>0.05)。 结论基层医院胸痛中心不断总结对急诊经绿色通道行PCI治疗STEMI患者的救治经验,并进一步优化绿色通道设置,值得临床推广应用。

Clinical characteristics of acute myocardial infarction patients undergoing emergency percutaneous coronary intervention: an analysis of 184 cases

ObjectiveTo analyze the clinical characteristics and the outcomes of patients with ST segment elevated myocardial infarction (STEMI)undergoing emergency percutaneous coronary intervention (PCI)via green channel in the Chest Pain Center of Wujin Hospital. MethodsThe clinical characteristics of 184 patients with STEMI who underwent emergency PCI treatment in our center from May 2017 to April 2019 were analyzed retrospectively. There were 147 males and 37 females. The age ranged from 27 to 95 years (mean 63.08 years). 112 cases more than 60 years old were divided into the elderly subgroup and 72 cases divided into the middle-aged or young subgroup. The clinical characteristics and parameters of operation, such as time of disease, time of D-to-B, number of diseased vessels and major adverse cardiovascular events (MACE) were compared between subgroups. ResultsCompared with female, male patients were younger and had lower HDL-C levels. However, the prevalence of smoking, alcohol consumption, the levels of body mass index (BMI), white blood cells (WBC), hemoglobin (HGB), uric acid (UA) and creatinine (Cr)were significantly higher in male group than those in female group. Compared with the young and middle-aged group, the prevalence of male, smoking, and hyperlipidemia were lower in the elderly group, while the prevalence of hypertension was higher (P<0.05). The levels of BMI, DBP, WBC, HGB, PLT and TG in the elderly group were significantly lower than those in the young and middle-aged group. Nevertheless, the HDL-C levels and GRACE score in the elderly group were significantly higher than in the young and middle-aged group (P<0.05). Furthermore, the number of vascular lesions in the elderly group was significantly higher than in the young and middle-aged group (P<0.05). There were no significant differences in major cardiovascular events between groups during hospitalization. ConclusionConsistently summarizing the plan of emergency PCI treatment and optimizing the green channel in the chest pain center in primary hospitals have the great value of clinical application.