摘要
目的评价辽宁省部分医院急性ST段抬高性心肌梗死（STEMI）患者的住院治疗情况。方法调查辽宁省7所医院2004年12月至2005年12月出院诊断为STEMI并且住院时间超过24h患者的病史资料，分析基线特征和治疗现状。结果在1239例接受调查的患者中，男性占69．4％，年龄（64．6±11、8）岁。早期再灌流治疗率为42．3％，其中33．3％接受急诊经皮冠状动脉介入治疗（PCI）治疗，9．0％接受溶栓治疗。阿司匹林的使用率95．9％、氯吡格雷64．3％、血管紧张素转换酶抑制剂，血管紧张素受体阻制剂（88．4％）、他汀类（94．9％）、低分子肝素（97．8％），县级医院上述用药比率低于市级和省级医院；而三组医院阻受体阻制剂的使用率差别不大，均达到75．0％。中药静脉应用达51．8％。住院期间发生的不良心性事件，如充血性心力衰竭、心源性休克、心搏骤停等，县级医院高于市级和省级医院，县级医院病死率最高。结论2005年辽宁省部分医院STEMI患者治疗情况与2004年美国心血管病学会，美国心脏学会（ACC／AHA）治疗指南的要求存在一定差距，应用中药患者超过半数，但尚缺乏循证医学依据。
Objective To evaluate the current state of treating hospitalized patients with acute ST segment elevation myocardial infarction （STEMI） in some hospitals in Liaoning province. Method The cross-sectional and retrospective survey of patients admitted from December 2004 to December 2005 was carried out. Hospitalized patients with discharged diagnosis of STEMI 7 hospitals were included from. The hospital stay more than 24 hours were included. The clinical characteristics and management was analyzed. Results A total of 1239 patients were included, 69.4% of them were male, and the was （64.6 ± 11.8） years old. Among these patients, 42.3% underwent reperfusion therapy, 33.3% underwent emergency pereutaneous coronary intervention （PCI）, and 9.0% received thrombulytic therapy. The rates of various medication employed medication in the 1239 patients were ： aspirin 95.9%, clupidagrel 64.3%, angiotensin-converting enzyme inhibitors/angiotensin-receptor blocker 88.4%, statins 94.9%, luw-molecular-weight heparin 97.8%. The use rate of above-mentioned medications in the county hospitals was lower than that in the municipal or provincial hospitals. The use rate of β-blockers reached 75.0%. Up to 51.8% of the patients received Chinese Traditional Medicine. The rate of MACE in the county hospitals was higher than that in the municipal or provincial hospitals. Mortality was the highest in the county hospitals. Conclusions There still existed gap in the STEMI treatment between ACC/AHA guidelines and some hospitals in Liaoning province. The Chinese traditional medicines were widely used, but still needs to be proved by evidence-based medicine.
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第3期326-329,共4页
Chinese Journal of Emergency Medicine
关键词
急性心肌梗死
溶栓治疗
中药疗法
Acute myocardial infarction
Thrombolytic therapy
Chinese Traditional Medicine
