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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (7): 118-122.doi: 10.6040/j.issn.1671-7554.0.2021.1549

• 临床医学 • 上一篇    下一篇

689例非ST段抬高型心肌梗死患者的临床流行病学特征

张玉凤1,2,徐敏3,邢秀丽3,逄曙光3,户克庆4   

  1. 1.山东大学齐鲁医学院, 山东 济南 250012;2.济南市历下区人民医院, 山东 济南 250014;3.山东大学附属济南市中心医院内分泌科, 山东 济南 250013;4.山东大学附属济南市中心医院胸痛中心, 山东 济南 250013
  • 发布日期:2022-07-27
  • 通讯作者: 逄曙光. E-mail:shugoangpang@163.com
  • 基金资助:
    山东省重点研发计划(2016GSF201019);济南市医疗卫生科技创新计划(201704116);山东大学横向计划(6020320001);山东省第一医科大学学术提升计划(2019QL205)

Epidemiological characteristics of 689 patients with non-ST-segment elevation myocardial infarction

ZHANG Yufeng1,2, XU Min3, XING Xiuli3, PANG Shuguang3, HU Keqing4   

  1. 1. Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Peoples Hospital of Lixia District of Jinan, Jinan 250014, Shandong, China;
    3. Department of Endocrinology, Jinan Central Hospital, Shandong University, Jinan 250013, Shandong, China;
    4. Chest Pain Center, Jinan Central Hospital, Shandong University, Jinan 250013, Shandong, China
  • Published:2022-07-27

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摘要： 目的 调查分析济南市某三甲医院胸痛中心就诊患者中非ST段抬高型心肌梗死患者的流行病学特征,探讨近3年该院胸痛中心就诊的非ST段抬高型心肌梗死患者的特点及规律。 方法 选取2018年1月至2020年12月到胸痛中心就诊的非ST段抬高型心肌梗死患者689例作为研究对象,按患者的性别、年龄、就诊时间及患者的首次医疗接触时间、处理策略等进行频数分析、卡方检验和Logistic回归分析。 结果 非ST段抬高型心肌梗死患者人数和构成比随年龄的增长逐渐增加,70岁~年龄组占比最高(53.4%),男性患者构成比高于女性;非ST段抬高型心肌梗死患者的就诊有明显的季节性,不同季节的患者昼夜就诊率差异有统计学意义(χ2=12.627,P=0.006)。对昼夜就诊有关联的影响因素进行二分类Logistic回归多因素分析显示,就诊季节、首次医疗接触时间及处理策略是患者昼夜就诊差异的独立影响因素(P<0.05)。 结论 该院非ST段抬高型心肌梗死患者就诊的高峰年龄、就诊时间段、季节分布有其规律可循,为临床医师识别高危患者、选择最佳诊疗策略提供依据。

关键词: 非ST段抬高型心肌梗死, 流行病学, 季节分布, 预后

Abstract: Objective To investigate the epidemiological characteristics of patients with non-ST-segment elevation myocardial infarction(NSTEMI), and to explore the characteristics and regularity of patients with non-ST-segment elevation myocardial infarction in chest pain center of the hospital in recent 3 years. Methods A total of 689 NSTEMI patients who visited the chest pain center of a certain hospital during Jan. 2018 and Dec. 2020 were selected as the study subjects. Frequency analysis, Chi-square test and Logistic regression analysis were performed based on patients gender, age, date and time of treatment, time of first medical contact and treatment strategy. Results The number of patients and constituent ratio increased with the increase of age. The 70-year group had the highest proportion, accounting for 53.4% of all cases. The proportion of male patients was higher than that of female patients. Patients in different seasons had statistically significant difference in day and night visit rates(χ2=12.627, P=0.006). Multinomial Logistic regression analysis showed that the season of visit, time of first medical contact and treatment strategy were the independent influencing factors of day and night visits(P<0.05). Conclusion The peak age, time period and seasonal distribution of patients have certain rules to follow, which can provide a basis for clinicians to identify high-risk patients and choose the best diagnosis and treatment strategy.

Key words: Non-ST-segment elevation myocardial infarction, Epidemiology, Seasonal prevalence, Prognosis

中图分类号: 

  • R541.4
[1] Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the management of patients with non-ST-Elevation acute coronary syndromes: a report of the american college of cardiology/american heart association task force on practice guidelines [J]. J Am Coll Cardiol, 2014, 64(24): 2713-2714.
[2] Park HW, Yoon CH, Kang SH, et al. Early- and late-term clinical outcome and their predictors in patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction [J]. Int J Cardiol, 2013, 169(4): 254-261.
[3] 杨欣, 王岚英. 336例急性心肌梗死流行病学分析[J]. 徐州医学院学报, 2005, 25(2): 163-164.
[4] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 非ST段抬高型急性冠状动脉综合征诊断和治疗指南(2016)[J]. 中华心血管病杂志, 2017, 45(5): 359-376. Chinese Society of Cardiology of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology. Guideline and consensus for the management of patients with non-ST-elevation acute coronary syndrome(2016)[J]. Chinese Video Journal of Cardiology, 2017, 45(5): 359-376.
[5] Menotti A, Puddu PE, Kromhout D, et al. Coronary heart disease mortality trends during 50 years as explained by risk factor changes: the European cohorts of the Seven Countries Study [J]. Eur J Prev Cardiol, 2020, 27(9): 988-998.
[6] 苏懿, 王磊, 张敏州. 急性心肌梗死的流行病学研究进展[J]. 中西医结合心脑血管病杂志, 2012, 10(4): 467-469.
[7] Salpeter SR, Cheng J, Thabane L, et al. Bayesian meta-analysis of hormone therapy and mort- ality in younger postmenopausal women [J]. Am J Med, 2009, 122(11): 1016-1022.
[8] Sivasinprasasn S, Shinlapawittayatorn K, Chattipakorn SC, et al. Estrogenic impact on cardiac ischemic/reperfusion injury [J]. J Cardiovasc Transl Res, 2016, 9(1): 23-39.
[9] Mefford MT, Li BH, Qian L, et al. Sex-specific trends in acute myocardial infarction within an integrated healthcare network, 2000 through 2014 [J]. Circulation, 2020, 141(7): 509-519.
[10] 韦再华, 高燕琳, 苏健婷, 等. 2003—2007年北京市户籍居民急性心肌梗死死亡人群分布特征[J]. 中华预防医学杂志, 2012, 46(7): 651-652.
[11] Paneni F, Diaz Cañestro C, Libby P, et al. The aging cardiovascular system: understanding it at the cellular and clinical levels [J]. J Am Coll Cardiol, 2017, 69(15): 1952-1967.
[12] Jackson AM, Zhang R, Findlay I, et al. Healthcare disparities for women hospitalized with myocardial infarction and angina [J]. Eur Heart J Qual Care Clin Outcomes, 2020, 6(2): 156-165.
[13] DeFilippis EM, Collins BL, Singh A, et al. Women who experience a myocardial infarction at a young age have worse outcomes compared with men: the Mass General Brigham YOUNG-MI registry [J]. Eur Heart J, 2020, 41(42): 4127-4137.
[14] Jiang SL, Ji XP, Zhao YX, et al. Predictors of in-hospital mortality difference between male and female patients with acute myocardial infarction [J]. Am J Cardiol, 2006, 98(8): 1000-1003.
[15] 李珊珊, 金玮. 气象因子影响急性心肌梗死的研究[J]. 国际心血管病杂志, 2012, 39(5): 295-297.
[16] Li K, Zhao K, Shi L, et al. Daily temperature change in relation to the risk of childhood bacillary dysentery among different age groups and sexes in a temperate city in China [J]. Public Health, 2016, 131(29): 20-26.
[17] Lee JH, Chae SC, Yang DH, et al. Influence of weather on daily hospital admissions for acute myocardial infarction(from the Korea Acute Myocardial Infarction Registry)[J]. Int J Cardiol, 2010, 144(1): 16-21.
[18] 蔡雪黎, 胡开宇, 计光, 等. 青年急性心肌梗死的临床特点[J]. 温州医学院学报, 2009, 39(3): 250-253. CAI Xueli, HU Kaiyu, JI Guang, et al. Clinical characteristics of acute myocardial infarction in the young patients [J]. Journal of Wenzhou Medical College, 2009, 39(3): 250-253.
[19] 国家卫生健康委员会. 2020中国卫生健康统计年鉴[M]. 北京: 中国协和医科大学出版社, 2020.
[20] 王妮妮, 刘娜, 王汝菲, 等. 55 岁以下急性冠状动脉综合征的影响因素分析[J]. 现代生物医学进展, 2020, 20(3): 565-568. WANG Nini, LIU Na, WANG Rufei, et al. Analysis of influencing factors in patients with acute coronary syndrome under 55 years old [J]. Progress in Modern Biomedicine, 2020, 20(3): 565-568.
[21] 蔡敏, 谢学勤, 吴士勇. 我国老年人口健康状况及卫生服务利用[J]. 中国卫生信息管理杂志, 2021, 18(1): 27-34,49. CAI Min, XIE Xueqin, WU Shiyong. Health status and services utilization of the elderly people [J]. Chinese Journal of Health Informatics and Management, 2021, 18(1): 27-34, 49.
[22] Morici N, De Rosa R, Crimi G, et al. Characteristics and outcome of patients ≥75 years of age with prior coronary artery bypass grafting admitted for an acute coronary syndrome [J]. Am J Cardiol, 2020, 125(12): 1788-1793.
[23] 柏哲, 毛燕, 罗玲, 等. 重庆地区居民对冠心病中西医科普知识认知情况调查[J]. 实用中医药杂志, 2019, 35(4): 431-434. BAI Zhe, MAO Yan, LUO Ling, et al. Investigation on Chongqing Residents Cognition Condition of 20 items Popular Science Knowledge of TCM and Western Medicine on Coronary Heart Disease [J]. Journal of Practical Traditional Chinese Medicine, 2019, 35(4): 431-434.
[24] 统计信息中心. 我国城乡居民医疗卫生服务可及性提高——《全国第六次卫生服务统计调查报告》发布[R]. 北京:国家卫生健康委员会统计信息中心, 2021.
[25] 李冬冬, 郭威, 郭轶斌, 等. 居住地距最近医疗机构的距离对居民就医行为的影响[J]. 中国卫生统计, 2020, 37(2): 269-271, 275.
[26] 许雅琼, 张银萍. 乳腺癌术后患者婚姻质量与负性情绪、社会支持的相关性[J]. 临床医学研究与实践, 2020, 5(1): 49-51. XU Yaqiong, ZHANG Yinping. Relationship between marital quality, negative emotion and social support in patients with breast cancer after operation[J]. Clinical Research and Practice, 2020, 5(1): 49-51.
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