【摘要】：目的:對2001-2011年南陽地區(qū)急性ST段抬高型心肌梗死(STEMI)患者的臨床特征、治療模式及院內(nèi)結(jié)局進行分析,旨在評價過去10年間該地區(qū)STEMI患者診療情況的變化趨勢。方法:隨機抽取2001、2006、2011年我院急性心肌梗死住院病歷,提取詳細(xì)臨床信息,分析其中STEMI患者臨床特征、治療模式和院內(nèi)結(jié)局。結(jié)果:本研究共抽取急性心肌梗死病歷234份,其中217例STEMI患者。結(jié)果顯示:2001-2011年,阿司匹林、氯吡格雷及他汀的應(yīng)用顯著增加(阿司匹林:2001年79%,2011年94%,P0.05;氯吡格雷2001年0%,2011年95%,P0.05;他汀2001年31%,2011年95%,P0.05),β受體阻滯劑和ACEI類藥物應(yīng)用率仍比較低,且10年間無明顯增加(β阻滯劑2001年51%,2011年55%,P0.05;ACEI類藥物2001年61%,2011年59%,P0.05);未進行再灌注治療的患者,并無顯著改變(2001年43%,2011年47%;P0.05);院內(nèi)病死率10年間變化差異無統(tǒng)計學(xué)意義(2001年9%,2011年10%;P0.05)。結(jié)論:過去10年間,南陽地區(qū)STEMI患者院內(nèi)再灌注率無明顯增加,病死率無顯著降低,二級預(yù)防用藥顯著不足。醫(yī)療實踐與指南之間的重要差距仍持續(xù)存在。
[Abstract]:Objective: to analyze the clinical characteristics, treatment mode and hospital outcome of patients with acute ST segment elevation myocardial infarction (STEMI) in Nanyang from 2001 to 2011, in order to evaluate the trend of diagnosis and treatment of STEMI patients in Nanyang during the past 10 years. Methods: the inpatients with acute myocardial infarction (AMI) in our hospital were randomly selected from 2001to 2006,2011, and detailed clinical information was extracted. The clinical characteristics, treatment mode and in-hospital outcome of the patients with STEMI were analyzed. Results: a total of 234 cases of acute myocardial infarction were collected, 217 of which were STEMI patients. The results showed that there was a significant increase in the use of aspirin, clopidogrel and statins between 2001 and 2011 (aspirin: 79 in 2001, 94 in 2011, P0.05; clopidogrel in 2001, 95 in 2011, P0.05; statins in 2001, 31 in 2011, 95 in 2011, P0.05), and the application rates of beta blockers and ACEI drugs were still relatively low. There was no significant increase in 尾 -blockers in 2001 (51R), 55P0.05ACEI in 2011 (61g in 2001, 595in 2011); there was no significant change in patients without reperfusion therapy (2001 43g, 2011 47g P 0.05), and there was no significant difference in the in-hospital mortality in 10 years (2001 9, 2011 10 P 0.05), and no significant change was found in the patients without reperfusion therapy (2001 43%, 2011 47% P 0.05), and there was no significant difference between them in 10 years (2001 9, 2011 10 P 0.05). Conclusion: in the past 10 years, the in-hospital reperfusion rate of STEMI patients in Nanyang area was not significantly increased, the mortality rate was not significantly decreased, and the secondary prophylaxis medication was significantly inadequate. Important gaps between medical practice and guidelines persist.
【作者單位】： 鄭州大學(xué)附屬南陽醫(yī)院南陽市中心醫(yī)院心內(nèi)科;
【基金】：衛(wèi)生公益性行業(yè)科研專項(No:201202025) 國家科技支撐計劃項目(No:2013BAI09B00)
【分類號】：R542.22

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