2018 年第 5 期 第 13 卷

首次医疗接触至球囊扩张时间对急性ST段抬高型心肌梗死患者心功能的影响

Effect of first medical contact-to-balloon time on cardiac function in patients with ST-segment elevation myocardial infarction

作者：付丽王楠杨柳吴其明宋毓青董茜

英文作者：

单位：100015首都医科大学附属北京地坛医院心内科

英文单位：

关键词：急性ST段抬高型心肌梗死；急诊经皮冠状动脉介入；首次医疗接触至球囊扩张时间

英文关键词：

• 摘要：

• 目的    探讨首次医疗接触至球囊扩张（FMC-to-B）时间对急性ST段抬高型心肌梗死（STEMI）患者心功能的影响。方法    纳入2016年5月至2017年6月在首都医科大学附属北京地坛医院通过胸痛中心行急诊经皮冠状动脉介入的STEMI患者255例，以FMC-to-B时间120 min为分界点，将患者分为FMC-to-B时间≤120 min组（91例）和FMC-to-B时间＞120 min组（164例）。比较2组入院后48 h内心功能和住院期间心力衰竭发生情况。结果    入院后48 h内2组患者左心室舒张末期内径和左心房内径比较，差异均无统计学意义（均P＞0.05）。FMC-to-B时间≤120 min组患者左心室射血分数高于FMC-to-B时间＞120 min组，住院期间心力衰竭发生率低于FMC-to-B时间＞120 min组［（51±8）%比（47±8）%、15.4%（14/91）比38.4%（63/164）］，差异均有统计学意义（均P＜0.05）。结论    缩短FMC-to-B时间可降低STEMI患者心力衰竭发生率，同时左心室射血分数更高。

• 【Abstract】Objective    To explore the effect of first medical contact-to-balloon（FMC-to-B） time on cardiac function in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods    Totally 255 acute STEMI patients who had emergency percutaneous coronary intervention from May 2016 to June 2017 in Beijing Ditan Hospital, Capital Medical University were enrolled; they were divided into FMC-to-B time≤120 min group（91 cases） and FMC-to-B time＞120 min group（164 cases）. Heart function parameters in 48 h after admission and occurrence of heart failure during hospitalization were analyzed. Results    Left ventricular end-diastolic dimension and left atrial diameter showed no significant differences between groups within 48 h after admission(P＞0.05). Left ventricular ejection fraction in FMC-to-B time≤120 min group was significantly higher than that in FMC-to-B time＞120 min group［（51±8）% vs （47±8）%］（P＜0.05）. Incidence rate of heart failure in FMC-to-B time≤120 min group was significantly lower than that in FMC-to-B time＞120 min group［15.4%（14/91） vs 38.4%（63/164）］（P＜0.05）. Conclusions    hortening FMC-to-B time can reduce the incidence of heart failure and increase left ventricular ejection fraction in acute STEMI patients.

  【Key words】Acute ST elevation myocardial infarction；Emergency percutaneous coronary intervention；First medical contact-to-balloon