2001-2011年中国中西部城市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AMI研究

发布时间：2018-03-01 21:00

本文关键词： 急性心肌梗死心肌标志物时间变化趋势　出处：《临床心血管病杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:研究2001-2011年我国中西部城市地区医院心肌标志物检测的普及情况,在急性心肌梗死(AMI)住院患者中的应用情况,及其10年来的时间变化趋势。方法:采用两阶段随机抽样我国中西部18省的城市地区医院在2001、2006、2011年因AMI住院患者的代表性样本,并对病历资料进行集中式信息提取,描述医院肌钙蛋白和肌酸激酶同工酶(CK-MB)检测的开展情况,及其在AMI患者中的检测率,并比较不同年份间的变化趋势。结果:来自中西部城市地区31家医院共计5 667份AMI病历纳入研究,其中三级医院28家,二级医院3家。2001年、2006年、2011年开展肌钙蛋白或CK-MB检测的医院比例分别为88.7%、97.6%、100%,其中开展肌钙蛋白检测的医院比例分别为39.6%、86.2%、97.9%,有显著统计学差异。在能够开展肌钙蛋白检测的医院中,AMI患者肌钙蛋白的检测率分布差异显著,2011年,有1/4的医院AMI患者肌钙蛋白检测率超过95%,而另外仍有1/4的医院不足50%。结论:2001-2011的10年间,中西部城市地区心肌标志物的检测已逐渐普及,但在有检测能力的医院尚未广泛应用于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 prevalence of myocardial markers in hospitals of central and western cities in China from 2001 to 2011, and the application of myocardial markers in patients with acute myocardial infarction (AMI). Methods: Two-stage random sampling was used to sample the representative samples of inpatients in 18 provinces of central and western China in 2001,2006,#date0# because of AMI, and the medical records were collected by centralized information extraction. This paper describes the development of hospital cardiac troponin and creatine kinase isoenzyme (CK-MBB) detection and its detection rate in patients with AMI. Results: a total of 5 667 AMI medical records from 31 hospitals in urban areas of central and western China were included in the study, of which 28 were tertiary hospitals. In 2001, 2006 and 2011, the proportion of hospitals with cardiac troponin or CK-MB was 88.797. 6 and 100, respectively. The proportion of hospitals with cardiac troponin detection was 39.6%, 86.2% and 97.9, respectively. There was significant difference in the number of hospitals that could carry out cardiac troponin detection. In 2011, there was a significant difference in the distribution of cardiac troponin in patients with acute myocardial infarction (AMI). In 1/4 hospitals with AMI, the detection rate of cardiac troponin is over 95%, while 1/4 hospitals are still less than 50%. Conclusion during the 10 years from 2001 to 2011, the detection of cardiac muscle markers in central and western cities has become more and more popular. However, it has not been widely used in the diagnosis of AMI in hospitals with testing ability, so it is necessary to further popularize the standardized diagnosis and treatment scheme, especially to improve the application rate of cardiac troponin detection, and to improve the accuracy and sensitivity of the identification and diagnosis of AMI patients.
【作者单位】：中国医学科学院
【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(No:201502009) 国家科技部科技支撑计划(No:2013BAI09B01,2015BAI12B01,2015BAI12B02) 高等学校学科创新引智计划(No:B16005)
【分类号】：R542.22

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