急性冠脉综合征患者冠脉介入治疗术后二级预防现况调查分析

Secondary prevention following percutaneous coronary intervention in patients with acute coronary syndrome: a survey and analysis

目的调查第二军医大学长海医院经皮冠状动脉介入治疗的急性冠脉综合征患者住院期间及出院后二级预防控制情况。方法收集2009年1月1日至2011年12月31日在第二军医大学长海医院行冠脉介入的急性冠脉综合征患者的病史资料。调查和分析住院期间以及出院后1个月、半年、1年时患者二级预防措施及药物使用情况。结果该研究分析了238例行经皮冠脉介入治疗的急性冠脉综合征患者资料。住院期间,吸烟患者被强制戒烟,阿司匹林、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体阻滞剂(ARB)、β受体阻滞剂和他汀类药物的使用率分别为96.6%、73.1%、68.9%和92.4%。出院后1个月、半年及1年时,阿司匹林的使用率分别为98.3%、95.8%和94.1%,ACEI/ARB的使用率分别为72.3%、69.7%和63.4%,β受体阻滞剂使用率分别为68.1%、62.2%和52.1%;他汀类药物使用率分别为91.6%、88.7%和83.6%;男性患者未吸烟率分别为86.4%、77.9%和78.6%,女性患者未吸烟率分别为100%、98.8%和98.8%;血压控制率分别为93.3%、95.4%和94.3%;血糖控制率分别为98.3%、96.2%和97.5%。结论急性冠脉综合征患者行经皮冠状动脉介入治疗后,二级预防各项措施在住院期间均很充分,出院后逐渐降低。因此,我们需进一步加强冠心病患者的随访和教育,增强冠心病二级预防的控制。

Objective To investigate the secondary prevention in acute coronary syndrome patients receiving percutaneous coronary intervention(PCI)during hospitalization and after discharge from Changhai Hospital.Methods The clinical data of patients with acute coronary syndrome undergoing PCI in Changhai Hospital from Jan 1st.2009to Dec 31st. 2011were collected.The status of secondary prevention and drug therapies was analyzed at 1month,six months and 1year after discharge.Results A total of 238patients with acute coronary syndrome receiving PCI were included in the present study.Smoking patients were forced to quit during hospitalization;the application rates of aspirin,angiotensin-converting enzyme inhibitors(ACEI)/angiotensinⅡreceptor blockers(ARB),β-blockers and statins among patients were 96.6%,73. 1%,68.9%and 92.4%,respectively.At 1month,6months and 1year after discharge,the application rates of aspirin among the patients were 98.3%,95.8%and 94.1%;of ACEI/ARB were 72.3%,69.7% and 63.4%;ofβ-blockers were 68.1%, 62.2%and 52.1%;and of statins were 91.6%,88.7% and 83.6%,respectively.At 1 month,six months and 1year after discharge,the non-smoking rates were 86.4%,77.9%and 78.6%in male patients and 100%,98.8%and 98.8%in female patients, respectively;the control rates of blood pressure were 93.3%,95.4%and 94.3%and those of blood glucose were 98.3%,96.2%and97.5%,respectively.Conclusion The secondary prevention is satisfactory during hospitalization in acute coronary syndrome patients undergoing PCI,but the situation gradually worsened after discharge;therefore efforts should be made to strengthen the follow-up and health education of the patients so as to reinforce secondary prevention for coronary heart disease.