目的 分析中青年急性心肌梗死（acute myocardial infarction，AMI）致心脏骤停（cardiac arrest，CA）发病特征及急救措施，探讨提高患者抢救成功率的方案。 方法 收集并整理郑州某院2019-2022年中青年AMI致CA患者329例的急救中心记录、院外急救人员记录及本院记录资料，分析其性别、年龄、急救响应时间、发病特点、病因及心电图等流行病学特征以及急救、并发症、转归情况，讨论急救措施的抢救效果。 结果 329例患者经抢救恢复自主循环174例（52.89%）。36~55岁年龄段死亡率高于其他年龄段（P=0.017），急救响应时间≤10 min患者死亡率低于急救响应时间＞10 min的患者（P=0.005）。有144例患者（43.77%）于00：00-08:00发病，且有237例患者（72.04%）发病时目击者未给予任何急救措施；146例患者（44.38%）的病因为冠状动脉硬化性心脏病，且有242例患者（73.56%）心电图表现为超急性T波改变；入院后，171例患者（51.98%）接受了肾上腺素推注，有19例患者（5.78%）发生用药后出血。 结论 中青年AMI致CA的急救成功率还有待提高，建议相关部门对大众进行院前急救知识的培训，并构筑全民急救体系。

Objective To analyze the epidemiological characteristics and first aid measures of cardiac arrest (CA) caused by acute myocardial infarction (AMI) among young and middle-aged patients, and to explore the scheme to improve the success rate of rescue. Methods Records of the emergency center,emergency personnel outside and inside the hospital of young and middle-aged CA patients caused by AMI in a hospital from 2019 to 2022 were collected and sorted out.Epidemiological characteristics such as gender,age,emergency response time,pathogenesis,etiology,electrocardiogram,as well as first aid,complications and outcome were analyzed, and the rescue effects of emergency measures were discussed. Results Among 329 patients,174 patients recovered their autonomic circulation after rescue（52.89%）.The mortality rate of patients aged 36 to 55 years was higher(P=0.017),and the mortality rate of patients with emergency response time≤10 minutes was lower than the ＞10 minutes group(P=0.005).144 patients (43.77%) had the onset between 00:00 and 08:00. 237 patients (72.04%) did not received first aids from others .146 patients (44.38%) with coronary artery disease history.242 patients (73.56%) showed hyperacute T wave changes on electrocardiogram.171 patients (51.98%) received adrenal cord injection after admission,and 19 patients (5.78%) had bleeding after medication. Conclusions The success rate of first aid for CA caused by AMI in young and middle-aged patients still needs to be improved. It is suggested that relevant departments should carry out pre-hospital first aid training for the public and build a national first aid system.

R472.2；R473

河南省2021年科技发展计划项目(212102310136)