| 王硕仁,刘红旭,赵冬,雷燕,王薇,尚菊菊,房玉涛,史载祥,黄毅,李清朗.北京地区1242例急性心肌梗死患者住院治疗状况调查[J].Chinese journal of Epidemiology,2006,27(11):991-995 |
| 北京地区1242例急性心肌梗死患者住院治疗状况调查 |
| Study on the therapeutic status of 1242 hospitalized acute myocardial infarction patients in Beijing |
| Received:April 13, 2006 |
| DOI： |
| KeyWord: 心肌梗死 治疗现状 |
| English Key Word: Acute myocardial infarction Currently status of therapies |
| FundProject:首都医学发展科研基金北京医学卫生科技联合攻关项目(2003-Ⅰ-04) |
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| Abstract: |
| 目的调查北京地区急性心肌梗死(AMI)救治水平及存在问题。方法采用统一调查表,对北京地区12家医院2000年1月至2001年3月的1242例AMI进行登记,以中国2001年《急性心肌梗死诊断和治疗指南》(《指南》)为评价依据,描述AMI的诊疗现状,并对影响病死率相关的因素进行单因素和多因素的分析。结果1242例AMI患者平均年龄63．0岁,1/3的患者年龄＜55岁。总病死率为9．10%。37．9%的患者进行了溶栓与急诊介入治疗,总再灌注治疗率56．0%。住院期间药物使用率,硝酸酯类药90．0%,阿司匹林87．8%,肝素88．7%,β受体阻滞剂73．4%,血管紧张素转化酶抑制剂(ACEI)77 6%,调脂药43．6%,活血、益气中药静脉点滴30．5%。多因素分析,可降低病死率的综合因素有再灌注治疗、调脂药物、静脉滴注中药、β受体阻滞剂、ACEI、低分子肝素和洋地黄。结论北京地区AMI治疗距《指南》的要求尚有一定差距,应建立AMI再灌注治疗的绿色通道,规范地遵循《指南》从事医疗实践,深入探讨中医药在AMI治疗中的地位,是面临的重要课题。 |
| English Abstract: |
| Objective To investigate and analyze the therapeutic level and the existing problems on acute myocardial infarction (AMI) management in Beijing.Methods We collected clinic data of 1242 AMI patients from 12 hospitals in Beijing,from January 2000 to March 2001,using a uniformed questionnaire, and evaluated the status of the diagnosis and treatment of AMI according to the Chinese guidelines issued on Decmeber 2001.Corresponding factors which influencing the mortality were also analyzed by one-way factor and multiple factors analysis methodologies.Results The mean age of the 1242 AMI patients was 63.0 years old and about one third of them were under 55 years old.In hospitals,the total mortality was 9.10 %.37.9 % of the patients had received therapy of the intravenous thrombolysis and emergency PCI with a total rate of reperfusion therapy as 56.0%.The in-hospital rates of drug use were as follows: Nitrates 90.0 %,Aspirin 87.8 %,heparin 88.7 %,beta-blockers 73.4 %,angiotensin converting enzyme inhibitors(ACEI) 77.6%,lipid regulating agents 43.6%.The rate of intravenous therapy of TCM by promoting the blood circulation and supplementing the vital energy was 30.5%.Results from multiple factors analysis showed that the compositive factors which could lower the mortality were reperfusion therapy,lipid regulating agents,intravenous therapy of TCM, beta-blockers,ACEI,lower molecule heparin and digitalis.Conclusion Data from this study showed that there still existed a gap between clinical management on AMI and the guideline in Beijing.To set up a straightway passage of reperfusion therapy, to become more standardized to follow the guideline in undertaking the medical treatment practice,and to go deep into discuss the status of TCM on AMI management seemed the important tasks we are facing |
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