2001—2011年东部城市急性心肌梗死住院患者阿司匹林早期使用趋势研究

发布时间：2018-10-20 08:48

【摘要】：背景阿司匹林可明确降低急性心肌梗死(AMI)患者的死亡风险,且适用范围广、效价比高,无禁忌证患者应尽早使用。东部城市AMI患者早期阿司匹林的使用情况尚不清楚。目的评价2001—2011年东部城市AMI患者早期阿司匹林使用率及变化趋势,并分析可能影响阿司匹林早期使用的因素。方法选取2001、2006及2011年3个年度,采用两阶段随机抽样方法抽取AMI病历,提取病历信息。分析患者在入院24 h内的阿司匹林使用率及10年变化趋势,采用多因素Logistic回归分析探讨其使用的影响因素。每年度分别进行加权计算,以代表东部城市整体情况。结果东部城市32家医院参加研究,随机抽取2001、2006、2011年3个年度无阿司匹林禁忌证的AMI住院患者5 522例,3个年度医院早期阿司匹林的加权使用率分别为80.3%、89.6%及90.2%(χ2趋势=1.300×10-10,P0.01)。2011年医院早期阿司匹林的使用率最低为62.1%(36/58)。多因素Logistic回归分析结果显示,年龄≥75岁、患有糖尿病、合并心源性休克的患者较少接受早期阿司匹林治疗,入院时存在胸部不适症状、接受再灌注治疗[包括溶栓治疗或行直接经皮冠状动脉介入治疗(PCI)]、入住年份为2006年或2011年、住在有PCI能力医院的患者早期阿司匹林使用率相对较高。结论东部城市AMI住院患者早期阿司匹林使用率相对较高,2001—2011年呈上升趋势,但仍有改善空间。
[Abstract]:Background Aspirin can definitely reduce the risk of death in patients with acute myocardial infarction (AMI) and has a wide range of application and high titer ratio. Patients without contraindication should be used as soon as possible. The early use of aspirin in AMI patients in eastern cities is unclear. Objective to evaluate the early use of aspirin and its changing trend in AMI patients in eastern cities from 2001 to 2011, and to analyze the factors that may influence the early use of aspirin. Methods two-stage random sampling method was used to extract AMI medical records in 2001 / 2006 and 2011. The use rate of aspirin and the change trend in 10 years were analyzed within 24 hours after admission. The influencing factors of aspirin use were analyzed by multivariate Logistic regression analysis. Each year will be weighted to represent the overall situation of the eastern city. Results 32 hospitals in eastern cities participated in the study. From 2001 to 2006, 5 522 AMI inpatients without contraindication of aspirin were randomly selected in 2011. The weighted use rate of aspirin in 3 years was 80.33% and 90.2% respectively (蠂 2 trend = 1.300 脳 10 ~ (-10) P 0.01). The lowest rate of early aspirin use was 62.1% (36 / 58) in 2011. Multivariate Logistic regression analysis showed that patients aged more than 75 years with diabetes and with cardiogenic shock were less likely to receive early aspirin therapy and had chest discomfort at admission. Patients undergoing reperfusion [including thrombolytic therapy or direct percutaneous coronary intervention (PCI)] were admitted in 2006 or 2011, and early aspirin use was relatively high in patients with PCI competence. Conclusion the early aspirin use rate of AMI inpatients in eastern cities is relatively high, and it is on the rise from 2001 to 2011, but there is still room for improvement.
【作者单位】：国家心血管病中心中国医学科学院阜外医院心血管病国家临床医学研究中心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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