2006-2011年中西部城市急性心肌梗死患者住院早期氯吡格雷的应用及影响因素

发布时间：2018-04-15 23:32

  本文选题：急性心肌梗死 + 氯吡格雷　； 参考：《临床心血管病杂志》2017年07期

【摘要】：目的:评价2006-2011年中西部城市地区急性心肌梗死(AMI)患者住院早期氯吡格雷的使用率及变化情况,并探讨影响其使用的因素。方法:采用两阶段随机抽样方法抽取2006年和2011年两个年份的AMI患者病历,提取临床信息,评估入院24h内氯吡格雷的应用情况。采用广义估计方程的多水平logistic回归模型分析影响因素。每年度分别进行加权计算,以代表中西部城市地区整体情况。结果:中西部城市共计32家医院的2 723份AMI病历纳入研究。中位年龄为63岁,女性患者占26.3%。2006-2011年,AMI患者住院早期氯吡格雷使用率从54.2%增加到87.7%(P0.01)。分析早期氯吡格雷使用的影响因素:入院有胸部不适、ST段抬高型心肌梗死、院内接受溶栓以及PCI患者更易接受氯吡格雷治疗,相反,年龄≥65岁、入院时收缩压≥180mmHg(1mmHg=0.133kPa)或舒张压≥110mmHg患者氯吡格雷使用率低于其他患者。结论:过去6年间,我国中西部城市地区AMI患者住院早期氯吡格雷应用得到显著改善,但仍然有改善空间。
[Abstract]:Objective: to evaluate the usage and changes of clopidogrel in inpatients with acute myocardial infarction (AMI) in urban areas of central and western China from 2006 to 2011, and to explore the factors affecting the use of clopidogrel.Methods: two stage random sampling method was used to select the medical records of AMI patients in 2006 and 2011, and the clinical information was extracted to evaluate the application of clopidogrel within 24 hours after admission.The multilevel logistic regression model of generalized estimation equation is used to analyze the influencing factors.Each year carries on the weight computation separately, to represent the central and western urban area overall situation.Results: a total of 2 723 AMI cases from 32 hospitals in central and western cities were included in the study.The median age was 63 years, and the percentage of female patients was 26.3%. The utilization rate of clopidogrel increased from 54.2% to 87.7% in early hospitalization of AMI patients from 2006 to 2011.The factors influencing the early use of clopidogrel: patients with chest discomfort and ST-segment elevation myocardial infarction, patients with thrombolytic therapy in hospital and patients with PCI were more likely to receive clopidogrel treatment.The usage rate of clopidogrel in patients with systolic blood pressure 鈮，

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