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目的:研究急性冠脉综合症(ACS)的临床特征、分析急诊科ACS处置情况、经皮冠状动脉介入(PCI)治疗对ACS短期与长期预后的影响。方法:收集2012年3月17日-2013年8月14日期间在我院急诊科首诊的年龄≥18岁确诊的急性冠脉综合征患者。记录患者临床资料、完成心电图时间、冠状动脉造影术结果,并对病例进行随访,记录7天、30天、6个月的全因死亡率。结果:本研究共收集了229例ACS患者,平均年龄为69±13岁,男性患者163例,占71%。ACS病例中,ST段抬高型心肌梗死(STEMI)122例,占53%,非ST段抬高性急性冠脉综合征(NSTE-ACS)107例,占47%(NSTEMI 42例,占18%、UA65例,占29%)。临床特征中,年龄、男性比例、体重,新发心绞痛病史、高血压史、既往心肌梗死病史、吸烟比例,就诊时心率、血压STEMI组和NSTE-ACS组比较均有显著性差异(P<0.05)。随访进行了直接经皮冠脉介入(PPCI)的ACS患者7天、30天、6个月全因死亡率,均明显低于非PCI组患者,有显著性差异。结论:STEMI与NSTE-ACS临床特征和高危因素均有差异,PPCI能对ACS患者的预后有获益。
Objective: To study the clinical features of acute coronary syndrome (ACS) and analyze the effects of ACS in emergency department and short-term and long-term prognosis of patients with percutaneous coronary intervention (PCI). Methods: Acute coronary syndromes diagnosed in the emergency department of our hospital aged ≥18 years were collected from March 17, 2012 to August 14, 2013. The clinical data of patients were recorded, the electrocardiogram time and coronary angiography results were completed, and the cases were followed up. All-cause mortality was recorded at 7 days, 30 days and 6 months. Results: A total of 229 ACS patients were collected in this study, with an average age of 69 ± 13 years and 163 male patients (71%). Of the ACS cases, 122 were ST-segment elevation myocardial infarction (STEMI), accounting for 53%, and 107 were non-ST-segment elevation acute coronary syndrome (NSTE-ACS), accounting for 47% %, UA65 cases, accounting for 29%). Among the clinical features, there were significant differences between the STEMI group and the NSTE-ACS group in age, male ratio, body weight, history of newly diagnosed angina, history of hypertension, past history of myocardial infarction, smoking rate, heart rate, ). All patients who underwent direct percutaneous coronary intervention (PPCI) were followed up for 7 days, 30 days and 6 months. All-cause mortality was significantly lower than that of non-PCI patients. There was a significant difference. Conclusion: The clinical features and risk factors of STEMI and NSTE-ACS are different. PPCI can benefit the prognosis of patients with ACS.