2001～2011年河北省急性ST段抬高型心肌梗死住院患者诊疗趋势

发布时间：2018-10-05 09:31

【摘要】：目的:评价2001~2011年间河北省急性ST段抬高型心肌梗死(STEMI)住院患者在临床特征、诊疗模式和结局方面的变化趋势。方法:本研究数据来源于中国冠心病医疗结果评价和临床转化研究(China PEACE)回顾性急性心肌梗死(AMI)研究。采用河北省8家医院(其中三级医院1家、二级医院7家)数据进行分析。选取2001、2006和2011年3个特定年份接受住院治疗且出院诊断为STEMI的患者病历。收集数据包括患者特征、诊疗经过、用药情况及患者结局等信息。结果:8家医院的832份STEMI病历纳入本研究。2001~2011年间,STEMI住院患者的年龄增高(2001、2006和2011年中位年龄分别为63.5岁、65.0岁和66.0岁,P=0.0097);女性比例无变化(2001、2006和2011年分别为30.1%、30.7%和30.3%,P=0.9846);心血管危险因素比例增高(2001、2006和2011年分别为69.9%、87.1%和87.0%,P0.0010)。在无相应禁忌证的患者中,再灌注治疗率无变化(P=0.8990);接受直接经皮冠状动脉介入治疗(PCI)比例无变化。药物阿司匹林、氯吡格雷、β受体阻滞剂、他汀、血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂(ACEI/ARB)使用率升高(分别为P0.0001、P0.0001、P=0.0172、P0.0001、P=0.0008)。2001、2006和2011年住院7天内病死率、死亡加放弃治疗率无变化(分别为P=0.5854、P=0.3516)。结论:河北省2001~2011年STEMI患者发病年龄、心血管病危险因素比例增高,冠心病二级预防药物使用率逐年增加,但再灌注治疗率未发生改变,STEMI患者7天内病死率未降低。
[Abstract]:Objective: to evaluate the clinical features, diagnosis and treatment patterns and outcome of acute ST segment elevation myocardial infarction (ST) in Hebei Province. Methods: the data were obtained from the evaluation of medical results and clinical transformation of coronary heart disease in China. (China PEACE) retrospective (AMI) study of acute myocardial infarction. The data of 8 hospitals in Hebei province were analyzed. The patients who were hospitalized in 2006 and 2011 and were diagnosed as STEMI were selected. Collect data including patient characteristics, diagnosis and treatment, drug use and outcome information. Results 832 STEMI medical records from 8 hospitals were included in the present study. [WT5HZ] the median age of inpatients with STEMI was 63.5 years in 2006 and 66.0 years in 2011 (P0. 0097); there was no change in the proportion of women (30. 1% and 30. 30.7% and 30. 3% P0. 9846, respectively, in 2001 and 2011); and cardiovascular risk. The proportion of risk factors increased (69.9% in 2006 and 87.0% in 2011). There was no change in the rate of reperfusion therapy (P0. 8990) and no change in the proportion of (PCI) receiving direct percutaneous coronary intervention in patients without corresponding contraindication. The use rate of aspirin, clopidogrel, 尾 receptor blocker, statins, angiotensin converting enzyme inhibitor / angiotensin receptor antagonist (ACEI/ARB) was increased (P 0.0001, P 0.0172, P 0.0001, P 0.0008). There was no change in the rate of death plus abandonment of treatment (P = 0.5854, P = 0.3516, respectively). Conclusion: from 2001 to 2011, the age of onset, the proportion of cardiovascular risk factors and the utilization rate of secondary prophylaxis of coronary heart disease in Hebei Province increased year by year, but the mortality rate of patients with STEMI did not decrease within 7 days after reperfusion therapy.
【作者单位】：河北北方学院附属第一医院心内科;河北北方学院;
【基金】：卫生公益性行业科研专项“冠心病医疗结果评价研究和临床转化研究”(201202025) 国家科技支撑计划项目“冠心病医疗质量改善研究”(2013BAI09B01) 张家口市科学技术研究与发展计划(1611054H)
【分类号】：R542.22

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