Schreiber W, Brunner M, Hödl W, Müllner M, Kratochwill C, Huber K
Notfallaufnahme, Universitätskliniken, AKH, Wien.
Wien Klin Wochenschr. 1994;106(20):652-5.
Effect of thrombolytic treatment in acute myocardial infarction depends on several factors, most importantly on time to treatment. The door-to-needle time, the interval between admission and thrombolytic therapy initiation, may be one important factor. In a retrospective study, we analysed 151 patients who were admitted to our emergency department with acute myocardial infarction and who received thrombolytic treatment. We analysed door-to-needle time with respect to the factors age, gender, clinical symptoms, presence of prehospital ECG, presence of prehospital complications, day of admission, hour of admission, duration of pain and infarct site. We observed that the door-to-needle time is significantly shorter in those cases with a prehospital ECG (p < 0.001) or no prehospital complications (p < 0.001) as well as inferior infarction (p < 0.02). There was a trend towards a shorter interval in cases with typical chest pain plus autonomic symptoms (p = 0.05). No statistical significance was seen in respect to age, gender, day and hour of admission, and duration of pain. Door-to-needle time with respect to thrombolytic treatment seems to depend on several factors in the preclinical field. Improvement of prehospital diagnosis and prevention of preclinical complications might result in faster thrombolytic treatment of the patient after arrival at the emergency department.
溶栓治疗对急性心肌梗死的疗效取决于多个因素，其中最重要的是治疗时间。入院至开始溶栓治疗的时间间隔（即门-针时间）可能是一个重要因素。在一项回顾性研究中，我们分析了151例因急性心肌梗死入住我院急诊科并接受溶栓治疗的患者。我们针对年龄、性别、临床症状、院前心电图情况、院前并发症情况、入院日期、入院时间、疼痛持续时间和梗死部位等因素分析了门-针时间。我们观察到，院前有心电图（p < 0.001）或无院前并发症（p < 0.001）以及下壁梗死（p < 0.02）的患者，其门-针时间显著缩短。有典型胸痛并伴有自主神经症状的患者，其时间间隔有缩短趋势（p = 0.05）。在年龄、性别、入院日期和时间以及疼痛持续时间方面未观察到统计学意义。溶栓治疗的门-针时间似乎取决于院前阶段的多个因素。改善院前诊断和预防院前并发症可能会使患者在到达急诊科后更快地接受溶栓治疗。
