Abstract: Background　Delayed treatment of acute ST-segment elevation myocardial infarction（STEMI） usually leads to prolonged total ischemia time and increased mortality.Regional cooperative rapid treatment system can shorten the treatment time of acute myocardial infarction and reduce the occurrence of adverse cardiovascular events.Objective　To explore the effect of the regional cooperative treatment system on the treatment efficiency and short-term prognosis of patients with acute STEMI.Methods　This study relied on the treatment data of patients with acute STEMI before and after the operation of the regional cooperative treatment system with the South Campus of the Sixth People's Hospital，Shanghai Jiao Tong University as the treatment center，and the treatment data were retrospectively analyzed.Patients who received emergency PCI therapy for acute STEMI were selected as the control group from April 2017 to March 2018（n=84），and the patients with acute STEMI from April 2018 to March 2019 were selected as the experimental group（n=122）.Patient's clinical data，from onset to the first medical contact（S-FMC） time，from first medical contact to balloon dilatation（FMC2B） time，from onset to balloon dilatation（S2B） time，from entering hospital door to balloon dilatation（D2B） time，standard-reaching rate of FMC2B time，standard-reaching rate of D2B time，whether combined with adverse cardiovascular events rate were collected and compared.Results　There was no significant difference in gender，age，history of coronary heart disease，history of previous PCI，history of cerebral infarction，history of angina pectoris before infarction，history of hypertension，history of diabetes，history of smoking，BNP，blood lipid index and distribution of criminal vessels between the two groups（P>0.05）.S-FMC and FMC2B were positively correlated with S2B〔rs =0.947，95%CI（0.924，0.963），P<0.001；rs=0.496，95%CI（0.381，0.591），P<0.001〕.S-FMC，FMC2B and D2B were positively correlated with S2B in self-admission group and calling ambulance group（P<0.05），while only S-FMC and FMC2B were positively correlated with S2B in non-PCI hospital referrals（P<0.05）.The time of S-FMC，FMC2B，S2B and D2B in the experimental group were shorter than those in the control group，while the proportion of ECG transmission through WeChat was higher，and the rates of adverse cardiovascular events were lower（P<0.05）.Conclusion　The regional cooperative treatment system can shorten the treatment time of acute myocardial infarction，improve the treatment efficiency，and reduce the occurrence of adverse cardiovascular events，which should be vigorously promoted.

Key words: Myocardial infarction, Center of the chest pain, The regional cooperative treatment system, Treatment outcome, Prognosis

摘要： 背景　急性ST段抬高型心肌梗死（STEMI）通常因救治延误导致患者总缺血时间延长、死亡率升高，区域协同救治体系可以缩短急性心肌梗死的救治时间，减少不良心血管事件的发生。目的　探讨区域协同救治体系对STEMI患者救治效率和短期预后的影响。方法　采用回顾性分析方法，资料来源于以上海交通大学附属第六人民医院南院为救治中心的区域协同救治体系运行前后的患者救治数据。以2017年4月—2018年3月至本院就诊且行急诊经皮冠状动脉介入治疗（PCI）的STEMI患者为对照组（n=84），以2018年4月—2019年3月的患者为研究组（n=122）。收集患者的临床资料，记录患者发病至首次医疗接触时间（S-FMC）、首次医疗接触至球囊扩张时间（FMC2B）、发病至球囊扩张时间（S2B）、进医院大门至球囊扩张时间（D2B）、FMC2B达标率、D2B达标率及不良心血管事件发生情况等，并比较两组上述指标的差异。结果　两组患者性别、年龄、冠心病史、既往PCI史、脑梗死史、梗死前心绞痛史、高血压史、糖尿病史、吸烟史、B型利钠肽（BNP）、血脂指标及罪犯血管分布比较，差异无统计学意义（P>0.05）。S-FMC、FMC2B与S2B呈正相关〔rs=0.947，95%CI（0.924，0.963），P<0.001；rs=0.496，95%CI（0.381，0.591），P<0.001〕。自行来院者、直接呼叫救护车来院者S-FMC、FMC2B、D2B与S2B呈正相关（P<0.05），而非PCI医院转院者只有S-FMC、FMC2B与S2B呈正相关（P<0.05）。研究组S-FMC、FMC2B、S2B、D2B短于对照组，微信心电图传输比例高于对照组，不良心血管事件发生率低于对照组（P<0.05）。结论　区域协同救治体系可以缩短STEMI患者的救治时间，提高救治效率，减少不良心血管事件的发生，建议加以推广。

关键词: 心肌梗死, 胸痛中心, 区域协同救治体系, 治疗结果, 预后