目的: 探讨医院胸痛中心对直接PCI的 STEMI患者的救治效果的影响。方法: 选取在巴彦淖尔市医院胸痛中心成立前行PCI的160例STEMI患者为对照组,胸痛中心成立后行PCI的200例STEMI患者为试验组,对两组患者一般临床资料、S2FMC和D2B等关键时间节点、就诊流程、住院天数、住院费用、院内主要并发症、出院3个月及1年MACE发生率等进行相关统计分析。结果: (1)两组入选者在年龄、性别、高血压、糖尿病、吸烟史、Scr、LDL-C、LVEF、LVEDD、病变血管数、梗死相关血管、置入支架数之间差异无统计学意义(P＞0.05);(2)试验组D2B平均时间82.54 min,较对照组的146.58 min减少64.04 min,且D2B达标比例增高(P＜0.05);(3)试验组住院天数(10.97±2.95)较对照组住院天数(12.3 ± 4.92)缩短(P＜0.05),但住院费用差异无统计学意义(P＞0.05);(4)试验组住院期间主要并发症、随访3个月及1年MACE较对照组降低(P＜0.05);(5)单因素Logistic回归分析结果显示年龄(OR=1.043,P＜0.001)、糖尿病(OR=2.325,P=0.019)、吸烟史(OR=1.726,P=0.035)、LVEF(OR=0.949,P＜0.001)为患者发生MACE的相关影响因素,其中年龄、LVEF与其显著相关。结论: 胸痛中心的成立可有效缩短STEMI患者闭塞血管缺血再灌注治疗时间(尤其是D2B 时间),减少患者住院天数,降低MACE发生率,改善患者预后,值得大力推广。

Objective: To explore the influence of establishment of chest pain center in treating STEMI patients with primary PCI. Methods: A total of 160 STEMI patients who underwent PCI before the establishment of the chest pain center in Bayannur Hospital were selected as the control group, and 200 STEMI patients who underwent PCI after the establishment of the chest pain center were selected as the experimental group. The general clinical data, key time nodes such as S2FMC and D2B, treatment process, hospitalization days, hospitalization expenses, major in-hospital complications, and the incidence of MACE 3 months and 1 year after discharge of the two groups were statistically analyzed. Results: There was no significant difference in terms of age, gender, hypertension, diabetes, smoking history, SCR, LDL-C, LVEF, LVEDD, number of diseased vessels, infarct vessels and number of stents between the two groups (P＞0.05). The average D2B time of the experimental group was 82.54 min, which was decreased 64.04 min and lower than that of the control group (82.54 min vs 146.58 min), and the difference was statistically significant (P＜0.05). Meanwhile, the proportion of D2B reaching the standard was increased. The length of stay in the experimental group shorter than that in the control group [(10.97 ± 2.95)d vs (12.3 ± 4.92)d], and the difference was statistically significant (P＜0.05), but there was no significant difference on hospitalization expenses between the two groups (P＞0.05). The main complications during hospitalization, MACE after 3 months of follow-up and 1 year of follow-up in the experimental group were lower than those in the control group, and the difference was statistically significant (P＜0.05). Univariate logistic regression analysis showed that age (OR=1.043, P＜0.001), diabetes (OR=2.325,P=0.019), smoking history (OR=1.726,P=0.035) and LVEF (OR=0.949, P＜0.001) were the related influencing factors of MACE in patients, and age and LVEF were significantly correlated with MACE. Conclusion: The establishment of the Chest Pain Center in Bayannur Hospital could effectively shorten the ischemia-reperfusion time (especially D2B time) of occluded vessels in STEMI patients, reduce the length of hospital stay, decrease the incidence of MACE, and improve the prognosis of patients, which is worthy of promotion.