2001-2011年急性心肌梗死住院患者强化他汀使用情况及其影响因素

发布时间：2018-07-11 09:31

本文选题：急性心肌梗死 + 强化他汀治疗　；参考：《实用医学杂志》2017年15期

【摘要】：目的评价2001-2011年间我院急性心肌梗死(AMI)住院患者强化他汀使用情况及其影响因素。方法调查我院2001、2006和2011年3个特定年份研究病历,提取临床信息。强化他汀治疗定义为通过他汀治疗使低密度脂蛋白胆固醇(LDL-C)预期降低至少40%。结果共计767例接受他汀治疗且有明确剂量的AMI患者病历纳入研究。AMI患者院内强化他汀的使用率从2001年的0%增加到2006年的60.77%和2011年的88.71%(P0.000 1)。多因素模型中,院内女性患者接受强化他汀治疗率明显低于男性(P=0.015),吸烟患者强化他汀治疗率显著高于高血压、糖尿病和高脂血症患者(P=0.008 1),LDL水平对他汀治疗情况没有显著影响(P=0.106);缺血性脑卒中患者强化他汀治疗率明显低于有心梗病史和冠心病史的患者(P=0.043 7);临床入院状态(胸痛、心源性休克和心脏骤停)不影响是否强化他汀治疗(P0.05);STEMI患者接受强化他汀治疗率显著低于NSTEMI患者(P0.000 1)。结论 AMI患者强化他汀治疗率逐年增加,且受性别、危险因素、疾病史和心肌梗死类型的影响。
[Abstract]:Objective to evaluate the use of intensive statins and its influencing factors in patients with acute myocardial infarction (AMI) in our hospital from 2001 to 2011. Methods the medical records of our hospital in 2006 and 2011 were investigated and the clinical information was extracted. Intensive statin therapy is defined as the expected reduction of low-density lipoprotein cholesterol (LDL-C) by at least 40 kW through statins. Results A total of 767 patients receiving statins with definite dosage of AMI were included in the study. The utilization rate of in-hospital intensive statins in AMI patients increased from 0% in 2001 to 60.77% in 2006 and 88.71% in 2011 (P0.000 1). In the multivariate model, the rate of intensive statin therapy in women was significantly lower than that in men (P0. 015), and that in smoking patients was significantly higher than that in hypertension. The level of LDL in patients with diabetes mellitus and hyperlipidemia (P0. 008 1) had no significant effect on the treatment of statins (P0. 106), whereas the rate of intensive statin therapy in patients with ischemic stroke was significantly lower than that in patients with a history of myocardial infarction and coronary heart disease (P0. 043 7). Cardiogenic shock and cardiac arrest did not affect the rate of intensive statin therapy in STEMI patients (P0.05) compared with NSTEMI patients (P0.000 1). Conclusion the rate of intensive statin therapy in AMI patients increases year by year, and is affected by sex, risk factors, history of disease and type of myocardial infarction.
【作者单位】：北京大学深圳医院心内科;
【基金】：卫生公益性行业科研专项项目(编号:201202025) 国家科技支撑计划项目(编号:2013BAI09B01)
【分类号】：R542.22

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