Clinical Features Of Chinese And Western Medicine And Predictors Of Short-term Outcomes In 549 Patients With Acute St-segment Elevation Myocardial Infarction

PurposeThe research was about the retrospective study of Acute ST-segment Elevation Myocardial Infarction in our hospital.Through summarizing the general situation,the characteristics of diagnosis and treatment of Chinese and Western Medicine,hospital complications,ending outcome of 549 patients with Acute ST segment Elevation Myocardial Infarction from 2013 to 2017.To explore the clinical features of Acute ST-segment Elevation Myocardial Infarction,the rule of auxiliary examination results,and the benefit of early reperfusion therapy as well as the risk factors of hospital death.So as to provide clinical evidence for the development of STEMI in Chinese Medicine and identify critical patients early.MethodThis study included 549 cases of Acute ST-segment Elevation Myocardial Infarction in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2013 to 2017.The patient's basic information,life habits,chronic medical history,prehospital delay time,ecg positioning and coronary angiography,Chinese and Western medicine treatment,and outcome were collected.Input data into spss 20.0 for analysis.The counting data is used to describe statistics and chi square test.T test for metering data.P < 0.05 was considered statistically significant.Multivariate logistic regression analysis was used to analyze the independent risk factors of death in hospital.P<0.05 was significant.Results1.The average age of patients with Acute ST-segment Elevation Myocardial Infarction in our hospital was 60.4±13.8 years,and the youngest was 22 years old.13.1% patients was less than 44 years old.The onset age was youngerand younger.In middle age,male onset is dominant in all ages,and the incidence of male and female is close after menopause.The average pre-hospital delay was higher than 12 h,with 147 people failing to go the hospital within12 hours,and missed the chance of reperfusion therapy.2.The electrocardiogram(ecg)positioning of 549 patients ranged from:anterior wall(41.5%),lower wall(31.3%),anterior wall(8.4%),lateral wall(1.5%),right ventricular(0.5%)and posterior wall(0.4%).Before angiography,the disease of the right coronary artery was dominant.The lesion vessels were more than 2 lesions.3.The treatment rate of reperfusion in our hospital was 69.9%,of which97.9% were interventional therapy.165 patients failed to perform early reperfusion.In terms of drug treatment,our hospital strictly adheres to the guideline of 2015 edition of acute st-segment elevation myocardial infarction.The coverage of secondary prevention strategies is extensive,but the utilization rate of anticoagulant therapy needs to be further improved.In addition,we use traditional Chinese medicine,traditional Chinese medicine,and external therapy.We fully developed the characteristics of traditional Chinese medicine.4.The early reperfusion therapy was lower than the failure of the early reperfusion group in the complications of cardiac death,cardiogenic shock,and heart failure.It can reduce the effect of myocardial infarction on left ventricular systolic function.5.This study shows that the typical chest pain,merge history of cerebrovascular disease,malignant arrhythmia,acute heart failure,cardiac shock,infection,Killip classification greater than the class II,early reascularization,vascular disease variables for three or left main lesion,age,systolic pressure,diastolic blood pressure,heart rate,white blood cells,left ventricular ejection fraction,TG,BUN and creatinine twenty project has a significant influence on hospital death.The factors of appeal were included in multivariate logistic regression analysis.The independent predictors of hospital death were age,typical chest pain,creatinine,cardiogenic shock,and malignant arrhythmia.The typical chest pain is protective factor,age,creatinine,cardiogenic shock,malignant arrhythmia as risk factors.ConclusionOur reperfusion therapy is closely related to the pre-hospital delay time.So we should strengthen the propaganda,popularize knowledge of STEMI,strengthen the consciousness of people to see a doctor.Our hospital adheres to the guidelines for the use of drugs.Besides,we uses TCM syndrome differentiation,including the combination of Chinese medicine and external therapy,to give full play to the combination of TCM and western medicine.Active reperfusion therapy is the best treatment to improve the prognosis of STEMI patients.We should pay attention to the prediction value of prognosis prediction by the patients of STEMI in our hospital with the age of typical chest pain creatinine complicated with cardiogenic shock and malignant arrhythmia.