胸痛中心模式联合麝香保心丸治疗对STEMI患者的影响

发布时间：2018-05-29 18:38

  本文选题：胸痛中心 + 急性心肌梗死　； 参考：《福建中医药大学》2017年硕士论文

【摘要】：第一章胸痛中心模式对STEMI患者的影响目的:探讨规范化胸痛中心急救模式对STEMI患者心肌总缺血时间及预后的影响。方法:连续入组经胸痛中心模式入院行急诊PCI的STEMI患者96例,与胸痛中心成立前经绿色通道入院行急诊PCI的STEMI患者121例进行比较,分为胸痛中心组与绿色通道组,收集患者临床一般资料、相关时间指标、冠脉造影资料、术后随访资料等。结果:1、两组患者D-to-B时间均明显缩短,特别是胸痛中心组,已达国际标准≤90min。胸痛中心组FMC-to-B时间、总缺血时间亦较绿色通道组改善,且均有统计学意义(P0.05)。2、胸痛中心组D-to-B时间、FMC-to-B时间达标率均明显高于绿色通道组。3、二分类 Logistic 回归分析显示,外院转入(OR=24.269,95%CI=11.101-53.058,P0.001)、高中及以上学历(OR=2.484,95%CI=1.163-5.306,P=0.019)是影响 FMC-to-B时间达标的独立预测因素。4、对急性心衰、术后24h内心绞痛、术后ST段回落50%、术中发生恶性再灌注心律失常及再灌注心律失常等差异有统计学意义(P均0.05);心源性死亡差异无统计学意义(P0.05)。结论:1、胸痛中心模式可以缩短心肌总缺血时间并提高D-to-B时间、FMC-to-B时间的达标率;2、外院转入及具有高中及以上学历与FMC-to-B时间存在一定相关性,可能是影响FMC-to-B时间达标的因素;3、胸痛中心模式能在一定程度上改善STEMI患者的预后。第二章胸痛中心模式联合麝香保心丸治疗对STEMI患者的影响目的:了解经胸痛中心模式入院行急诊PCI的STEMI患者术后联合麝香保心丸治疗是否能带来进一步的临床获益。方法:将96例胸痛中心组患者采用随机分组法分为麝香保心丸组和常规药物组,两组均予冠心病二级预防药物,麝香保心丸组加用麝香保心丸(2粒,3/日),共随访3个月,观察心功能分级、心绞痛分级、BNP及CRP指标。结果:麝香保心丸组与常规药物组心绞痛症状均有改善,两组心绞痛分级差异有统计学意义(P=0.0360.05),对心功能、BNP、CRP 无影响(P0.05)。结论:经胸痛中心模式入院行急诊PCI的STEMI患者术后联合麝香保心丸能够改善患者心绞痛症状。
[Abstract]:Chapter 1 the effect of chest pain Center Model on STEMI patients objective: to explore the effect of standardized chest pain center emergency mode on myocardial ischemia time and prognosis in patients with STEMI. Methods: 96 STEMI patients who were admitted to emergency PCI through chest pain center were compared with 121 STEMI patients who were admitted through green channel before the establishment of chest pain center. They were divided into chest pain center group and green channel group. Collect the general clinical data, relevant time index, coronary angiography data, postoperative follow-up data and so on. Results the D-to-B time of the two groups was significantly shorter than that of the control group, especially in the central group of chest pain, which had reached the international standard of 鈮，

本文编号：1951970