中国东部农村急性心肌梗死早期β受体阻滞剂使用趋势十年回顾性研究

发布时间：2018-06-08 23:00

本文选题：β受体阻滞剂 + 急性心肌梗死　；参考：《中国实用内科杂志》2017年06期

【摘要】：目的评价2001—2011年中国东部农村急性心肌梗死(AMI)早期(入院24 h内)β受体阻滞剂的使用情况。方法两阶段随机抽样设计,选2001、2006和2011三个特定年份,抽取AMI病历,进行中心性病历信息提取。评价东部农村AMI患者β受体阻滞剂在入院24 h内的使用变化趋势及影响因素。结果抽样获取无β受体阻滞剂禁忌证的AMI病历1227份,其中584例早期使用β受体阻滞剂存在高休克风险,其余643例绝对适宜。2001、2006和2011年β受体阻滞剂早期使用绝对适宜人群的使用率分别为43.5%、62.3%和57.6%(趋势P=0.0944),而高休克风险的人群所占比例为35.3%、50.2%和51.9%(趋势P=0.0206)。年龄偏高、有慢性肺病史的患者较少接受早期β受体阻滞剂治疗;反之,就诊于教学医院的患者更易接受此治疗。结论 2001年至2011年我国东部农村地区AMI患者,适宜早期应用β受体阻滞剂的理想人群中,使用率明显不足,而具有高休克风险的患者仍在普遍使用。提示可作为AMI诊疗质量改善的一个靶点。
[Abstract]:Objective to evaluate the use of 尾 -blockers in the early stage of acute myocardial infarction (AMI) in rural areas of eastern China from 2001 to 2011 (within 24 hours of admission). Methods two-stage random sampling design was used to extract the central medical records from three specific years: 2001 ~ 2006 and 2011. Objective: to evaluate the trend and influencing factors of 尾 -blocker use in patients with AMI in eastern rural areas within 24 hours after admission. Results 1227 cases of AMI without contraindication of 尾 -blocker were sampled. Among them, 584 cases were at high risk of shock after early use of 尾 -blocker. In the remaining 643 cases, the rates of early use of 尾 -blockers in 2006 and 2011 were 43.5% and 57.6%, respectively (trend P: 0.0944), while the proportion of people at high risk of shock was 35.30.2% and 51.9% (trend P0.0206). Patients with a history of chronic lung disease were less likely to receive early 尾 -blocker therapy, whereas patients in teaching hospitals were more likely to receive this treatment. Conclusion from 2001 to 2011, the use rate of 尾 -blocker in the ideal population of AMI patients in rural areas of eastern China is obviously insufficient, while the patients with high risk of shock are still widely used. The results suggest that it can be used as a target to improve the diagnosis and treatment quality of AMI.
【作者单位】：国家心血管病中心中国医学科学院阜外医院国家心血管疾病临床医学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(201502009) 国家科技部科技支撑计划(2013BAI09B01,2015BAI12B01,2015BAI12B02)
【分类号】：R542.22

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