目的：分析急性非 ST 段抬高心肌梗死（NSTEMI）患者介入治疗时机与长期结局的关系。方法：选择948例急性 NSTEMI 患者纳入研究。根据 NSTEMI 介入治疗方案分为早期介入治疗（48 h 内接受介入治疗，411例）组及晚期介入治疗（≥48h 接受介入治疗，537例）组。根据 TIMI 危险评分又分为低危、中危、高危三个亚组，比较各组的长期临床结局。结果：随访1年，与晚期介入组比较，早期介入组住院死亡率（4.8％比2.2％）和主要不良心血管事件发生率（MACE，13.4％比10.0％）明显降低（P 均＜0.01）；早期介入组中，中低危患者住院死亡率显著低于高危患者（3.3％比8.9％，P ＜0.01）。多元回归分析结果表明，老年及高 Killip 分级、左室射血分数减低、高 TIMI 危险评分、晚期介入治疗是 NSTEMI 患者长期临床结局的独立危险因素（OR＝1.027～2.079，P＜0.05或＜0.01）。结论：早期介入治疗对于高危险的急性非 ST 段抬高型心肌梗死患者有改善预后的作用。%Objective:To analyze relationship between early intervention treatment and long-term prognosis in pa-tients with acute non-ST segment elevation myocardial infarction (NSTEMI).Methods:A total of 948 acute NSTE-MI patients were enrolled.According to NSTEMI intervention treatment timing,they were divided into early inter-vention group (received intervention treatment within 48h n=411,)and late intervention group (received interven-tion treatment after48h,n=537).According to TIMI risk score,the two groups were further divided into low risk subgroup,medium risk subgroup and high risk subgroup,the clinic long-term outcome was compared among all groups.Results:Compared with late intervention group,during one year follow-up,there were significant reduction in mortality during hospitalization (4.8% vs.2.2%)and incidence rate of major adverse cardiovascular events (MACE,13.4% vs.10.0%)in early intervention group,P <0.01 both;in early intervention group,mortality dur-ing hospitalization of low and medium risk patients was significantly lower than that of high risk patients (3.3% vs. 8.9%,P <0.01).Multi-factor regression analysis indicated that aged,high Killip class,reduced left ventricular e-jection fraction,high TIMI risk score and late intervention treatment were independent risk factors for clinic long-term outcome in NSTEMI patients (OR=1.027~2.079,P <0.05 or <0.01).Conclusion:Early intervention treat-ment can improve prognosis in NSTEMI patients.
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