天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (6): 474-478.

• 新冠专题 • 上一篇    下一篇

新型冠状病毒肺炎流行期间AMI救治状况的临床研究 #br#

刘寅 1#，路鹏举 1#，高明东 1，肖健勇 1，李春洁 1，李长平 2，王慧 2，王霁翔 1，张楠 1，李晓卫 1，赵海旺 1， 豆静 1，白苗娜 1，石雨田 1，赵佳 2，昝淳 1，高静 3△，郭志刚 1△   

  1. 1天津市胸科医院（邮编300222）；2天津医科大学公共卫生学院；3天津市心血管病研究所
  • 收稿日期:2020-03-04 修回日期:2020-03-14 出版日期:2020-06-15 发布日期:2020-06-15
  • 通讯作者: 高静，郭志刚 E-mail:gzg@vip.163.com

Clinical study on the treatment status of acute myocardial infarction during the epidemic of coronavirus disease 2019

LIU Yin1#, LU Peng-ju1#, GAO Ming-dong1, XIAO Jian-yong1, LI Chun-jie1, LI Chang-ping2, WANG Hui2, WANG Ji-xiang1, ZHANG Nan1, LI Xiao-wei1, ZHAO Hai-wang1, DOU Jing1, BAI Miao-na1, SHI Yu-tian1, ZHAO Jia2, ZAN Chun1, GAO Jing3△, GUO Zhi-gang1△   

  1. 1 Tianjin Chest Hospital, Tianjin 300222, China; 2 College of Public Health, Tianjin Medical University; 3 Tianjin Cardiovascular Institute
  • Received:2020-03-04 Revised:2020-03-14 Published:2020-06-15 Online:2020-06-15

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摘要： 摘要:目的 研究新型冠状病毒肺炎（COVID-19）流行期间心肌梗死（AMI）救治现状。方法 本研究为同期横 断面研究，以2019年1月20日—2019年2月20日天津市胸科医院收治的AMI患者为对照组（非COVID-19流行期间 组：314例），2020年1月20日—2020年2月20日COVID-19流行期间收治的AMI患者为观察组（COVID-19流行期间 组：133例），比较2组住院期间临床结局（全因病死率）、24 h内AMI患者接受再灌注治疗比例、发病到首次医疗接触 （FMC）时间、急性ST段抬高型心肌梗死（STEMI）人群从进门至球囊扩张时间（D-to-B）和总缺血时间等指标。结果 住院期间COVID-19流行期间组院内全因病死率显著高于非流行期间组（14.3% vs. 1.6%，P＜0.01）。2组间24 h内再灌 注治疗比例差异无统计学意义（46.6% vs. 40.6%，P＞0.05），与非COVID-19流行期间组比较，COVID-19流行期间组的 FMC时间明显延迟（P＜0.05）。STEMI人群中，COVID-19流行期间组D-to-B时间和总缺血时间较非流行期间组明显 延长（P＜0.01）。结论 COVID-19流行期间AMI患者就诊时间延迟，院内急救时间延长，院内全因死亡率明显升高。 应当在遵循COVID-19防控原则基础上，优化AMI救治流程，尽早建立COVID-19流行期间正常的医疗秩序。

关键词: 心肌梗死, 新型冠状病毒肺炎, 再灌注, 临床结局, 死亡率

Abstract: Abstract: Objective To study the status of acute myocardial infarction (AMI) during the epidemic of coronavirus disease 2019 (COVID-19). Methods This study was a cross-sectional study of the same period. The AMI treated in Tianjin Chest Hospital from January 20 to February 20, 2019 was used as the control group (non-COVID-19 epidemic period group: 314 patients). The AMI treated during the COVID-19 epidemic period from January 20 to February 20, 2020 was the observation group (COVID-19 epidemic group: 133 cases). The indicators including clinical outcome (all-cause mortality), the ratio of AMI receiving reperfusion treatment within 24 hours, the time from onset to the first medical contact (FMC), the time from door to balloon (D-to-B), and total ischemic time were compared between two groups. Results The all-cause mortality during hospitalization was significantly higher in the COVID-19 epidemic group than that in the nonepidemic group (14.3% vs. 1.6%, P＜0.01). There was no significant difference in the proportion of reperfusion treatment within 24 hours between the two groups (46.6% vs. 40.6%, P＞0.05). The FMC time was significantly delayed in the COVID- 19 epidemic group compared with that of the non-COVID-19 epidemic group (P＜0.01). In the STEMI population, the Dto-B time and the total ischemic time were longer in the COVID-19 epidemic group than those in the non-epidemic group (P＜0.01). Conclusion During the epidemic of COVID-19, the patient's consultation time was delayed, the in-hospital emergency time was prolonged and the all-cause mortality in hospital was significantly increased. Based on the principles of COVID-19 prevention and control, the AMI treatment process should be optimized to restore normal medical order as soon as possible.

Key words: myocardial infarction, coronavirus disease 2019, reperfusion, treatment outcome, mortality