2025 年第 1 期 第 0 卷

规范化胸痛中心建设对和田地区急性冠状动脉综合征患者急诊经皮冠状动脉介入救治效率的影响

The effect of the construction of standardized chest pain center on the treatment efficiency of emergency percutaneous coronary intervention in patients with acute coronary syndrome in Hotan prefecture

作者：卡地尔·依米提  克热穆江·麦图荪  吐送江·吾斯曼  尼加提江·米孜  马热亚·吾布力  穆太力普·麦麦提江  张海玲  于晓滨

英文作者：Kadier Yimiti Keremujiang Maitusun Tusongjiang Wusiman Nijiatijiang Mizi Mareya Wubuli Mutailipu Maimaitijiang Zhang Hailing Yu Xiaobin

单位：新疆维吾尔自治区和田地区人民医院心血管内科，和田848000

英文单位：Department of Cardiovascular Medicine People′s Hospital of Hotan Prefecture in Xinjiang Uygur Autonomous Region Hotan 848000 China

关键词：急性冠状动脉综合征；  规范化胸痛中心；  经皮冠状动脉介入

英文关键词：Acutecoronarysyndrome;  Standardizedchestpaincenter;  Percutaneouscoronaryintervention

• 摘要：

• 目的  探讨在和田地区建设规范化胸痛中心对该地区急性冠状动脉综合征（ACS）患者接受急诊经皮冠状动脉介入（PCI）救治效率的影响。方法  回顾性分析2021年1月至2022年4月在新疆维吾尔自治区和田地区人民医院就诊并确诊为ACS患者共445例，所有患者均接受急诊PCI治疗。其中规范化胸痛中心认证前通过急诊绿色通道模式（2021年1—8月）就诊的225例ACS患者纳入对照组；规范化胸痛中心认证通过后（2021年9月至2022年4月）就诊的220例ACS患者纳入观察组。比较2组患者的一般资料、院内主要不良心血管事件（MACE）发生率、其中确诊为ST段抬高型心肌梗死（STEMI）患者的再灌注救治效率指标以及住院天数、住院费用等情况。结果  2组患者糖尿病史比例比较，差异有统计学意义（P＜0.05）。2组患者院内心源性休克发生率比较，差异有统计学意义（P＜0.05），观察组患者院内MACE总发生率明显低于对照组［10.9%(24/220)比17.8%(40/225)］，差异有统计学意义(P=0.039)。规范化胸痛中心认证通过后的STEMI患者的发病至首次医疗接触时间、首次医疗接触至球囊扩张时间、入门至球囊扩张缺血时间、导管室激活时间均低于急诊绿色通道模式STEMI患者，差异均有统计学意义（均P＜0.05）。观察组患者平均住院时间及平均住院费用均低于对照组［（7.7±2.1）d比（8.3±2.6）d、（28 353±9 071）元比（30 163±10 203）元］，差异均有统计学意义（均P＜0.05）。结论  规范化胸痛中心建设可有效提高ACS患者院内救治效率，减少心肌缺血时间，降低患者MACE发生率，缩短住院时间，节省医疗费用。

• Objective  To investigate the effect of the construction of standardized chest pain center on the treatment efficiency of emergency percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) in Hotan area. Methods   A total of 445 patients diagnosed with ACS in People′s Hospital of Hotan Prefecture in Xinjiang Uygur Autonomous Region from January 2021 to April 2022 were retrospectively analyzed. All patients underwent emergency PCI.Among them, 225 ACS patients who underwent emergency green channel mode (from January to August 2021) before standardized chest pain center certification were included in the control group. A total of 220 ACS patients who were admitted to the hospital after the certification of standardized chest pain center (from September 2021 to April 2022) were included in the observation group. The general information, the incidence of in-hospital major adverse cardiovascular events (MACE), the reperfusion treatment efficiency index of patients diagnosed with ST-segment elevation myocardial infarction (STEMI), the length of hospital stay, and hospitalization expenses were compared between the two groups. Results   There was statistically significant difference in the proportion of patients with diabetes history between the two groups (P＜0.05). There was statistically significant difference in the incidence of in-hospital cardiogenic shock between the two groups (P＜0.05). The total incidence of in-hospital MACE in the observation group was significantly lower than that in the control group ［10.9%(24/220) vs 17.8%(40/225)］(P=0.039). The time from onset to first medical contact, the time from first medical contact to balloon dilatation, the ischemic time from door to balloon dilatation, and the activation time of catheterization laboratory in STEMI patients after the certification of standardized chest pain center were lower than those in STEMI patients under emergency green channel mode (all P＜0.05). The average hospitalization time and average hospitalization cost of the observation group were lower than those of the control group［(7.7±2.1)d vs (8.3±2.6)d, (28 353±9 071)yuan vs (30 163±10 203)yuan］(both P＜0.05). Conclusion   The construction of standardized chest pain center can effectively improve the efficiency of in-hospital treatment of ACS patients, reduce the time of myocardial ischemia, reduce the incidence of MACE, shorten the length of hospital stay, and save medical costs.