Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.%目的：探讨胸痛中心（CPC）对不同来院方式接受直接经皮冠状动脉介入治疗（PPCI）的ST段抬高急性心肌梗死（STEMI）患者进门-球囊（D-to-B）时间的影响。方法根据来院方式不同将CPC成立前、后接受PPCI的STEMI患者分别分为自行来院组[A1组（52例）和A2组（65例）]、呼叫“120”组[B1组（31例）和B2组（92例）]、非经皮冠状动脉介入治疗（PCI）医院转诊组[C1组（23例）和C2组（552例）]，比较同一来院方式的两组间D-to-B时间和D-to-B达标率的变化，分析延迟原因。结果 A1、A2组平均D-to-B时间分别是（123±78）min和（140±123）min，达标率分别为44.2%和46.2%，两组间比较，差异均无统计学意义（P＞0.05）；B2组平均D-to-B时间显著短于B1组[（89±66）min比（155±115）min，P＜0.05]，而达标率显著高于B1组（69.6%比32.3%，P＜0.05）；C2组平均D-to-B时间显著短于C1组[（77±43）min比（337±662）min， P＜0.05]，达标率显著高于C1组（75.7%比21.7%，P＜0.05）。自行来院组的主要延迟原因是签署知情同意书时间过长，呼叫“120”组和非PCI医院转诊组的主要延迟原因是导管室占台。结论区域协同救治模式CPC显著缩短了呼叫“120”和转诊入院患者的D-to-B时间，但需加强对自行来院途径的院内流程优化。
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