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目的探讨影响急性心肌梗死(AMI)患者院前延误时间(PDT)的相关因素。方法回顾性分析2004年3月至2006年10月北京安贞医院抢救中心收治的807例AMI患者的临床资料。将就诊时间与发病时间的时间差作为PDT,根据PDT将患者分为≤2h和﹥2h两组,分析年龄、性别、文化程度、吸烟、饮酒、高血压病史、糖尿病史、脑血管病史、冠心病或心绞痛史、来院时心率、血压、发病时间、季节、地点以及来院交通方式等因素对PDT的影响。结果PDT﹥2h组与PDT≤2h组比较,女性较多(114例,86例),年龄偏大[(62.0±12.9)岁,(59.0±12.9)岁],夜间发病者较多[136例(33.6%),103例(25.6%)],继往有糖尿病史者较多[114例(28.2%),87例(21.7%)]而吸烟者少[222例(55.9%),265例(66.9%)]。多元Logistic回归分析显示,年龄、糖尿病史、夜间发病和乘急救车来院就诊与患者院前延误相关(P﹤0.05)。结论年龄、糖尿病史、夜间发病以及乘急救车来院就诊是影响PDT的相关因素。加强患者及家属对AMI相关知识的认识、及时就诊,有助于AMI患者的救治及AMI患者病死率的降低。
Objective To investigate the influencing factors of prehospital delay time (PDT) in patients with acute myocardial infarction (AMI). Methods The clinical data of 807 AMI patients admitted to the Rescue Center of Beijing Anzhen Hospital from March 2004 to October 2006 were retrospectively analyzed. According to the PDT, the patients were divided into two groups: ≤2h and> 2h. The factors such as age, gender, educational level, smoking, drinking, history of hypertension, history of diabetes, history of cerebrovascular disease, coronary heart disease Or history of angina pectoris, heart rate, blood pressure, onset time, season, location and the mode of transportation to the hospital to PDT. Results There were more women (114 cases, 86 cases) with PDT> 2h group and PDT≤2h group (older than 62.0 ± 12.9 years, 59.0 ± 12.9 years old) (33.6%) and 103 patients (25.6%). There were more patients with previous history of diabetes (114 patients (28.2%), 87 patients (21.7%) and fewer smokers (66.9%)]. Multivariate Logistic regression analysis showed that age, history of diabetes, nighttime onset and ambulance hospital visits were associated with delayed hospital stay (P <0.05). Conclusions Age, diabetes mellitus, nocturnal onset and emergency ambulance visits are the related factors affecting PDT. Patients and their families to enhance awareness of AMI-related knowledge, timely treatment, is helpful for the treatment of patients with AMI and AMI patients with reduced mortality.