2001～2011年东部农村地区医院急性心肌梗死心肌标志物检测的变化趋势——China PEACE回顾性急性心肌梗死研究

发布时间：2018-04-01 11:33

本文选题：心肌梗死　切入点：生物学标记　出处：《中国循环杂志》2017年06期

【摘要】：目的:研究2001~2011年间我国东部农村地区医院急性心肌梗死(AMI)住院患者中心肌标志物检测的使用情况,及其十年变化趋势。方法:研究采用两阶段随机抽样我国东部13省32家医院的农村地区医院在2001年、2006年和2011年因AMI住院的代表性样本,并集中进行病历信息提取,描述医院中具备肌钙蛋白和肌酸激酶同工酶(CK-MB)检测能力的比例,以及在AMI患者中的检测率,比较不同年份间的变化趋势。结果:将来自东部农村的32家医院共2 853份AMI病历纳入研究,其中三级医院5家,二级医院27家。2001年、2006年和2011年开展肌钙蛋白或CK-MB检测的医院比例分别为64.0%、97.4%、100%。其中开展肌钙蛋白检测的医院比例分别为29.3%、70.5%、82.0%,差异有统计学意义(P=0.0001)。在能够开展肌钙蛋白检测的医院中,AMI患者的检测率分布差异显著,仅2011年,有四分之一的医院AMI患者检测肌钙蛋白比例超过90%,另外仍有四分之一的医院AMI患者这项检测比例不足50%。结论:2001~2011年的十年间,东部农村地区心肌标志物的检测已逐渐普及,但即使在有检测能力的医院中,尚未广泛应用于AMI的诊断。因此有必要进一步推广规范化的诊疗方案,特别是提高肌钙蛋白检测的应用率,改善AMI患者识别诊断的准确性和敏感性。
[Abstract]:Objective: to study the use of myocardial markers in acute myocardial infarction (AMI) patients in rural hospitals in eastern China from 2001 to 2011. Methods: a two-stage random sampling of 32 hospitals in rural areas in 13 eastern provinces of China was conducted in 2001, 2006 and 2011 for AMI. Describe the proportion of hospitals with the ability to detect troponin and creatine kinase isozymes (CK-MBs) and the rate of detection in patients with AMI. Results: a total of 2 853 AMI medical records from 32 hospitals in rural areas in the east of China were included in the study, of which 5 were tertiary hospitals. In 2001, 2006 and 2011, the proportion of hospitals carrying out cardiac troponin or CK-MB detection was 64.0 and 97.4 / 100, respectively. The proportion of hospitals with cardiac troponin detection was 29.3and 70.5 / 82.0, respectively. The difference was statistically significant (P = 0.0001). There was a significant difference in the distribution of the detection rate among the patients with AMI. In 2011 alone, more than 90 percent of AMI patients in hospitals tested for troponin, while 1/4 in hospitals tested less than 50 percent of AMI patients. The detection of myocardial markers in rural areas of eastern China has gradually been popularized, but even in hospitals with detectable capacity, it has not been widely used in the diagnosis of AMI. Therefore, it is necessary to further popularize the standardized diagnosis and treatment scheme. Especially improve the application rate of cardiac troponin detection and improve the accuracy and sensitivity of AMI patients.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院国家心血管病临床研究中心心血管疾病国家重点实验室中国牛津国际医学研究中心;
【基金】：国家卫生和计划生育委员会卫生公益性行业科研专项(201202025,201502009) 国家科技部科技支撑计划(2015BAI12B01,2015BAI12B02) 高等学校学科创新引智计划(B16005)
【分类号】：R542.22

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