在STEMI患者中,尽管整体情况有所改善,但在医院预先延迟的持续性差异:来自中国心血管协会胸痛中心注册表的调查结果
Zhenzhen Lu1, Tongtong Zang2, Hao Li1
1Department of Biostatistics, Zhongshan Hospital Fudan University Shanghai China.
Journal of the American Heart Association
|February 26, 2026
概括
在中国,患有ST段升高心肌梗塞 (STEMI) 的女性比男性面临更长的医院前延误. 这些差异仍然存在,原因是紧急医疗服务 (EMS) 呼叫启动延迟,需要针对妇女进行有针对性的干预.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 从历史上看,与男性相比,患有ST段升高心肌梗塞 (STEMI) 的女性在入院前的延迟时间较长.
- 这种性别差异在中国缩小的程度仍然是一个重要的临床问题.
研究的目的:
- 调查中国STEMI患者的医院前延迟的趋势和特征.
- 为了确定医院前延迟的性别差异是否随着时间的推移而持续或缩小.
- 确定导致性别差异的医院前延迟的组成部分.
主要方法:
- 来自中国心血管协会数据库-胸部疼痛中心 (2016-2023) 的大量STEMI患者队列的分析.
- 利用多变量量子回归来分析三个时间段的总医院前延迟及其组成部分.
- 根据主要的人口和临床因素进行调整,包括年龄,并发症和心血管风险因素.
主要成果:
- 总共有1,104,812名STEMI患者被分析;14.7%被紧急医疗服务 (EMS) 运送.
- 女性总是比男性出现更长的医院前延误 (平均差异为24.44分钟),在更高的百分位数中,差异变得更大.
- 虽然整体延迟减少了,但性别差异仍然存在,特别是在年轻人 (<80岁) 和农村人口中,主要是由于EMS呼叫延迟.
结论:
- 尽管中国STEMI患者的医院前延迟时间总体有所改善,但性别差异仍然很大.
- 这些差异在很大程度上归因于在EMS激活之前发生的延迟,突出了女性在症状识别和寻求帮助行为方面的问题.
- 针对性策略重点关注早期症状识别和迅速激活EMS对于妇女至关重要,需要针对农村地区的具体实施.
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