【摘要】 目的 :探讨急性心肌梗死 (AMI)患者在溶栓和冠脉介入治疗 (PCI)时 ,入院前时间和其他危险因素的改变对出院转归的影响。方法 :整理近些年来我院收治典型 AMI患者 14 5例。将院前时间、心肌梗死范围等作自变量 ,出院转归作为因变量 ,采用逐步回归法检验两者关系。结果 :发病到急诊室时间 11.1± 4 .5 h,急诊室抢救时间 4 .7±1.6 h,两者对出院转归有显著影响 (回归系数分别为 0 .0 0 4 X3- 0 .0 10 X4 ,复相关系数 R=0 .4 730 ,剩余标准差 =0 .2 6 0 8,F=5 .2 2 0 ,P<0 .0 1) ,并分别占全部自变量因素第 6和第 9位。发病到急诊室时间越短及急诊室抢救时间越长 ,出院转归越好。从发病到住院时间越长对出院转归也不利。心肌梗死范围 ,对转归影响占第 1位。心律失常与并发症对出院转归作用与文献 [1]排位相同。其他相关危险因素也对出院转归有较大影响。结论 :10年来对 AMI溶栓和 PCI等 ,患者从发病到急诊室 ,急诊室抢救时间与其他相关危险因素等大多均有不等程度变化 ,也影响或改变了患者短期出院转归更多还原

【Abstract】 AIM:To investigate the effects of duration before admission and other main risk factors on the discharge and conversion of patients with acute myocardial infarction(AMI) in recent 10-years. METHODS:145 AMI patients were analysed by regression stepwise. RESULTS:The time from the attacks of AMI to the emergency room of the hospital was 11.1±4.5 h,and the time for emergency room treatement was 4.7±1.6 h,which showed marked influence on the patients discharge and convertion(individually regression 0.004X 3-0.010X 4,Multiple R=0.4730,Root MSE=0.2608,F=5.220, P <0.01), and which are standing on the sixth and nineth lines. The shorter the time from the attacks of AMI to the emergency room of the hospital was, and the longer the time for emergency room treatment was,the better were longer duration before admission was unfavorable for short-term prognosis. And it was also showed that AMI size, which ranked the first(F=6) in all factors also play a more important role in patients’ short-term prognosis, arrhythmia ranking 2nd and ranking 5th complications is similar to both reported before. Most other factors work also powerfully upon discharge and convertion. CONCLUSION:Over the 10 years of thrombolytic and PCI therapy for AMI patients,there have been some changes in duration before admission and other main risk factors, have influenced patients’ discharge and convertion to different degrees.更多还原