【摘要】 【目的】探讨临床症状、治疗方法等认知水平对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)决策的影响。【方法】选择2021年7月至2022年7月本科室收治的195例STEMI住院患者，根据是否进行急诊PCI将患者分为急诊PCI组(n=68)和非急诊PCI组(n=127)。比较两组患者急性心肌梗死(AMI)主要临床症状、AMI发作时第一反应及治疗方法知晓情况。【结果】急诊PCI组接受健康教育比例显著高于未急诊PCI组，院前就诊延迟比例显著低于未急诊PCI组，差异均有统计学意义(P<0.05)。急诊PCI组患者知晓胸部突然疼痛或不适、突然气促或呼吸困难是AMI发病症状的比例显著高于非急诊PCI组，差异有统计学意义(P<0.05)。急诊PCI组患者AMI发作时第一反应为呼叫120急救车和联系就近社区医院以寻求建议的比例显著高于非急诊PCI组，差异有统计学意义(P<0.05)。急诊PCI组患者知晓PCI是AMI治疗方法的比例显著高于非急诊PCI组，不知晓AMI治疗方法的比例显著低于非急诊PCI组，差异有统计学意义(P<0.05)。多因素Logistic回归分析显示，知晓AMI发作时会出现突然气促或呼吸困难的症状、知晓PCI,以及AMI发作时的第一反应是呼叫120急救车、联系就近医院医生寻求建议是STEMI患者行急诊PCI决策的独立保护因素(P<0.05)。【结论】STEMI患者急诊PCI所占比例过低，AMI主要临床症状、AMI发作时第一反应及治疗方法等认知水平显著影响STEMI患者急诊PCI决策。更多还原

【Abstract】 【Objective】To explore the influence of cognitive level of clinical symptoms, treatment methods and other related knowledge on the decision-making of emergency percutaneous coronary intervention(PCI) in patients with ST-segment elevation myocardial infarction(STEMI). 【Methods】A total of 195 inpatients with STEMI admitted to our department from July 2021 to July 2022 were selected. According to whether emergency PCI was performed, the patients were divided into the emergency PCI group(n=68) and the non-emergency PCI group(n=127). The awareness of main clinical symptoms of acute myocardial infarction(AMI), first reaction when AMI occurred and treatment methods was compared between the two groups. 【Results】The proportion of receiving health education in the emergency PCI group was significantly higher than that in the non-emergency PCI group, and the proportion of pre-hospital treatment delay was significantly lower than that in the non-emergency PCI group, with statistically significant differences(P<0.05). The proportion of patients in the emergency PCI group who knew that sudden chest pain or discomfort, sudden shortness of breath or dyspnea were the onset symptoms of AMI was significantly higher than that in the non-emergency PCI group, with a statistically significant difference(P<0.05). The proportions of patients in the emergency PCI group whose first reaction to AMI was to call 120 emergency ambulance and contact the nearest community hospital for advice were significantly higher than those in the non-emergency PCI group, with statistically significant differences(P<0.05). The proportion of patients in the emergency PCI group who knew that PCI was a treatment method for AMI was significantly higher than that in the non-emergency PCI group, and the proportion of those who did not know the treatment method for AMI was significantly lower than that in the non-emergency PCI group, with a statistically significant difference(P<0.05). Multivariate Logistic regression analysis showed that knowing the symptom of sudden shortness of breath or dyspnea when AMI occurs, knowing PCI, as well as the first reaction of calling 120 emergency ambulance and contacting doctors of the nearest hospital for advice when symptoms occur were independent protective factors for AMI patients to make emergency PCI decisions(P<0.05).【Conclusion】 The proportion of STEMI patients receiving emergency PCI is too low. The cognitive level of main clinical symptoms of AMI, first reaction when AMI occurs and treatment methods significantly affects the emergency PCI decision-making of STEMI patients.更多还原