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目的 探讨新疆维吾尔自治区人民医院急性ST段抬高性心肌梗死(ST-elevation myocardial infarction,STEMI)患者行急诊经皮冠状动脉介入治疗(primary percutaneous coronary intervention,PPCI)的入门-球囊扩张时间(door-to-balloon time,DTBT),并对其影响因素进行分析.方法 回顾性分析新疆维吾尔自治区人民医院心内科2010年1月至2013年3月连续收治的行PPCI的STEMI患者的病历资料464例,记录患者一般资料(性别、族别、年龄、文化程度、高血压史、糖尿病史等),DTBT及其组分(中位数时间):急诊科初诊时间、心内科总住院医师紧急会诊时间、获取知情同意时间、联系导管室并转运时间、导管室准备时间,并依据DTBT分为两组:短时间组(≤90 min)和长时间组(＞90 min),应用Logistic回归分析影响DTBT的因素.结果 短时间组157例(33.8％),长时间组307例(66.2％),与短时间组相比,长时间组文化程度(大专以上)患者较少(48.5％比62.4％,P=0.005),不典型胸痛患者较多(13.0％vs.3.8％,P=0.002),基本了解心脏病的患者较少(57.7％vs.81.5％,P=0.000),家庭成员数量多的患者较多(63.8％ vs.36.3％,P=0.000),外院二次转运的患者较多(48.5％ vs.26.8％,P=0.000),非工作时间就诊患者较多(73.3％vs.21.7％,P=0.000).总DTBT为111 min,急诊科初诊时间8 min,心内科总住院紧急会诊时间11 min,获取知情同意时间73 min,联系导管室并转运时间6min,导管室准备时间8 min.Logistic回归分析表明:影响DTBT延长(＞90 min)的因素为非工作时间就诊(OR =5.76,95％ CI:1.17 ～28.38,P=0.031),获取知情同意的时间(OR=1.43,95％CI:1.24～1.66,P=0.000),导管室准备时间(OR=1.36,95％ CI:1.10 ～ 1.68,P=0.005).结论 非工作时间就诊患者多、获取知情同意时间较长以及导管室准备时间延长主要延迟了DTBT,因此要进一步加强对公民的相关知识宣传教育,改善沟通方式,健全有效的非工作时间急诊流程,从而缩短DTBT.“,”Objective To analyze the door-to-balloon time (DTBT) in our hospital and identify the factors significantly prolonging the DTBT in patients with ST-elevation myocardial infarction (STEMI).Methods A total of 464 consecutive patients presenting with STEMI admitted from January 2010 to March 2013 were enrolled for study.The data of demographics of patients including gender,age,ethnic,education,and history of hypertension and diabetes mellitus were recorded.The course of DTBT was proceeded (calculated in median time) through the following algorithm beginning from the time required for the first diagnosis made in emergency department,time consumed for calling cardiologist for consultation,time elapsed for obtaining informed consent,time consumed for catheter available,and time required for preparation in the catheterization laboratory (CL) was recorded and analyzed.The DTBT was divided into short-time group (≤ 90 min) and long-time group (＞ 90 min),and the factors significantly influencing DTBT prolonged were determined by using binary Logistic regression.Results Of them,157 (33.8％) patients were in short-time group and 307 (66.2％) patients in long-time group.Compared with short-time group (≤90 min),the long-time group (＞ 90 min) had less patients with high education (48.5％ vs.62.4％,P =0.005),more patients presented in atypical chest pain (13.0％ vs.3.8％,P =0.002),less patients with well-understanding heart disease (57.7％ vs.81.5％,P =0.000),more patients with large family members (63.8％ vs.36.3％,P =0.000),more patients referred to from other hospitals (48.5％vs.26.8％,P =0.000),more patients presented during leisure hours (73.3％ vs.21.7％,P =0.000).The median time of DTBT was 111 min calculated from 8 min for the first diagnosis,11 min for call cardiologist consultation,73 min for obtaining informed consent,6 min for catheter available,8 min for preparation in the CL.Binary Logistic regression showed that patients presented STEMI during non-working hours (OR =5.76,95％ CI:1.17-28.38,P =0.031),the time for obtaining informed consent (OR =1.43,95％ CI:1.24-1.66,P =0.000) and the time for preparation in the catheterization laboratory (OR =1.36,95％ CI:1.10-1.68,P =0.005) were significant factors of ＞90 min DTBT.Conclusions In our hospital,many patients presented STEMI were during non-working hours.The long time for obtaining informed consent and for preparation in the CL delayed DTBT significantly.Several measures including the popularization of medical knowledge to the citizens,improving the way of communication and the process of emergency treatment should be made to shorten the DTBT.