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投稿时间：2021-04-30 网络发布日期：2021-11-20
投稿时间：2021-04-30 网络发布日期：2021-11-20
中文摘要: 目的 研究分析新型冠状病毒肺炎（COVID-19）不同时期防控措施对急性ST段抬高型心肌梗死（STEMI）住院患者的救治和院内病死率影响。方法 回顾性分析苏州大学附属第三医院心内科2019年1月25日至2019年2月25日（COVID-19非流行期间组）、2020年1月25日至2020年2月25日（COVID-19一级响应组）、2021年1月25日至2021年2月25日（COVID-19常态化防控组）三个时期的STEMI住院患者，比较分析不同疫情防控措施下研究对象的就诊时间、治疗策略、首次医疗接触时间（FMC）、球囊扩张时间（D-to-B）以及院内全因病死率等指标。结果 共纳入107例STEMI患者，其中非流行期间组37例，一级响应组28例，常态化防控组42例；三组急诊溶栓和FMC以及D-to-B时间差异有统计学意义（P＜0.05）；COVID-19一级响应组的FMC时间［14.0(7.0,21.3)min］显著长于非流行期间组［8.0(5.0,10.0) min］和常态化防控组［5.0(4.0,6.5) min］(P＜0.05)，D-to-B时间较非流行期间组显著延长［87.5(68.8,116.3)h vs 67.5(55.0,91.3)h，P＜0.05］；一级响应组院内病死率显著高于常态化防控组（28.6% vs 4.8%，P＜0.05）；一级响应组非PCI患者病死率高于PCI患者（17.4% vs 80.0%，P＜0.05）。结论 COVID-19一级响应期间STEMI患者急诊再灌注的救治时间延长，在遵循COVID-19防控原则基础上，通过优化STEMI的救治流程可以降低院内全因死亡率。
中文关键词: ST段抬高型心肌梗死 新型冠状病毒肺炎 再灌注 病死率
Abstract:Objective To study and analyze the impacts of different prevention and control measures of COVID-19 on the treatment of hospitalized patients with acute ST segment elevation myocardial infarction (STEMI) and on in-hospital mortality of STEMI. Methods The patients with STEMI were respectively enrolled from those admitted to hospital between January 25, 2019 and February 25,2019 (COVID-19 non-epidemic group),between January 25, 2020 and February 25, 2020 (COVID-19 primary response group) and between January 25, 2021 and February 25, 2021(COVID-19 normalized prevention and control group). The treatment time and strategy， the first medical contact (FMC)time, balloon dilation (door-to balloon, D-to-B)time and all-cause mortality in hospital were retrospectively analyzed and compared under different prevention and control measures for COVID-19 epidemic. Results A total of 107 patients with STEMI were enrolled, including 37 cases in non-epidemic group, 28 cases in primary response group and 42 cases in normalized prevention and control group. There were significant differences in the time for thrombolysis, FMC and D-to-B time among three groups (P<0.05). FMC time in primary response group［14.0 (7.0,21.3) min］ was significantly longer than those in non-epidemic period group ［8.0 (5.0,10.0) min］ and normalized prevention and control group ［5.0 (4.0,6.5) min］ (P<0.05), and D-to-B time was significantly longer than that in non-epidemic period group ［87.5 (68.8, 116.3)h vs 67.5 (55.0,91.3) h, P<0.05］.The in-hospital mortality in primary response group was significantly higher than that in normalized prevention and control group (28.6% vs 4.8%, P<0.05). The mortality of patients without undergoing PCI was statistically higher than that of PCI patients in primary response group (17.4% vs 80.0%, P<0.05). Conclusions During the primary response to COVID-19 epidemic, the re-perfusion treatment time for STEMI patients is prolonged. The all-cause mortality in hospital can be reduced by optimizing emergency strategy of STEMI based on the principles of COVID-19 pandemic prevention and control.
文章编号： 中图分类号：R452.2 文献标志码：A
基金项目:江苏省临床医学科技专项（BL2012042）；江苏省医学创新团队(CXTDC2016013)
附件
| 作者 | 单位 |
| 王强1 | 1. 苏州大学附属第三医院心内科，江苏 常州 213003； |
| 杨承健2 | 2. 南京医科大学附属无锡市第二人民医院心内科，江苏 无锡 214001； |
| 杨玲1 | 1. 苏州大学附属第三医院心内科，江苏 常州 213003； |
| 苏彤1 | 1. 苏州大学附属第三医院心内科，江苏 常州 213003 |
| Author Name | Affiliation |
| WANG Qiang*, YANG Cheng-jian, YANG Ling, SU Tong | *Department of Cardiology, the Third Affiliated Hospital of Soochow University, Changzhou， Jiangsu 213003, China |
引用文本：
王强,杨承健,杨玲,等.COVID-19防控对急性ST段抬高型心肌梗死住院患者救治的影响[J].中国临床研究,2021,34(11):1495-1498.
王强,杨承健,杨玲,等.COVID-19防控对急性ST段抬高型心肌梗死住院患者救治的影响[J].中国临床研究,2021,34(11):1495-1498.