摘要目的:基于潜在剖面分析行静脉溶栓治疗的急性心肌梗死（AMI）患者代理决策者参与溶栓决策困境的类别特征，以降低行静脉溶栓治疗的AMI患者代理决策者决策困境。方法:便利抽样法选取2022年1月至2023年6月新疆维吾尔自治区人民医院急诊科收治行静脉溶栓治疗的AMI患者代理决策者292例为调查对象。选择一般资料问卷、领悟社会支持量表、状态特质焦虑问卷、决策参与期待量表、维克森林医师信任量表和决策困境量表对其进行横断面调研。选择Mplus8.3软件对调研资料进行潜在剖面分析。结果:最终回收有效问卷281份，281例患者中男146例，女135例，年龄35~72（55.61 ± 9.05）岁；代理决策者男135名，女146名，年龄30~72（55.52 ± 6.74）岁。行静脉溶栓治疗的AMI患者代理决策者参与溶栓决策困境得分为45（41，46）分。潜在剖面分析结果显示，代理决策者参与溶栓决策困境包括4个潜在类别：低决策困境类占16.01%（45/281）、高决策困境类占16.38%（46/281）、支持限制性特高决策困境类占35.23%（99/281）和信息限制性特高决策困境类占32.28%（91/281）。多分类Logistic回归分析可得，所代理患者有AMI史和代理决策者年龄、性别、文化程度、决策角色、决策参与类型是高决策困境类代理决策者参与溶栓决策困境显著影响因素（均 P<0.05）；所代理患者有AMI史和代理决策者年龄、性别、文化程度、决策角色、承担患者治疗付费角色、承担患者住院照顾角色、领悟社会支持、状态焦虑、决策参与类型、对医师信任是支持限制性高决策困境类和信息限制性特高决策困境类代理决策者参与溶栓决策困境显著影响因素（均 P<0.05）。 结论:行静脉溶栓治疗的AMI患者代理决策者参与溶栓决策困境水平相对较高，可分为低决策困境类、高决策困境类、支持限制性特高决策困境类和信息限制性特高决策困境类，应根据他们不同类别决策困境进行针对性干预。

abstractsObjective:Based on latent profile analysis, the category characteristics of decisional dilemma of participating in thrombolysis decision-making agents of patients with acute myocardial infarction (AMI) are analyzed to reduce the decision-making difficulties of decision-making agents in AMI patients.Method:The 292 cases of decision-making agents of patients with AMI and treated by intravenous thrombolysis in emergency department of Xinjiang Uygur Autonomous Region People's Hospital were selected as respondents From January 2022 to June 2023.A cross-sectional survey was conducted using General Information Questionnaire, Perceived Social Support Scale, State-Trait Anxiety Inventory, Control Preference Scale, Wake Forest Physician Trust Scale and Decisional Conflict Scale.Selected Mplus 8.3 software to conduct potential profile analysis on the survey data.Results:The 281 valid questionnaires were ultimately collected, with 146 males and 135 females aged 35-72(55.61 ± 9.05) among 281 AMI patients; 135 acting decision-makers from the south, 146 females, aged 30-72(55.52 ± 6.74).The score of decisional dilemma of participating in thrombolysis of decision-making agents of patients with AMI was 45(41, 46). LPA analysis showed that decisional dilemma of participating in thrombolysis of decision-making agents can be divided into 4 latent profiles which were low-level decisional dilemma profile accounts for 16.01% (45/281), high-level decisional dilemma profile accounts for 16.38% (46/281), extra high-level decisional dilemma profile with social support restricting accounts for 35.23% (99/281) and extra high-level decisional dilemma profile with information restricting accounts for 32.28% (91/281). Multiple logistic regression analysis showed represented patients with AMI history, decision-making agent ′s age, gender, educational level, decision-making role, decision-making participation type were significant influencing factors of decisional dilemma of participating in thrombolysis of high-level decisional dilemma profile (all P<0.05);represented patients with AMI history, decision-making agent ′s age, gender, education level, decision-making role, assuming patient ′s treatment payment role, assuming patient ′s care role, perceived social support level, state anxiety level, decision-making participation type and trust doctors level were significant influencing factors of decisional dilemma of participating in thrombolysis of extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting(all P<0.05). Conclusions:The level decisional dilemma of participating in thrombolysis of decision-making agents for intravenous thrombolysis treatment of AMI patients were high, and their decisional dilemma can be divided into low-level decisional dilemma profile, high-level decisional dilemma profile, extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting.They should be purposively intervened based on their corresponding decisional dilemma profile.