胶南市1992、1997及2002年急性心肌梗死住院病例回顾性调查

IN-PATIENTS WITH ACUTE MYOCARDIAL INFARCTION IN 1992,1997 AND 2002 IN JIAONAN CITY——A RETROSPECTIVE INVESTIGATION

目的了解胶南市10年来急性心肌梗死住院病人流行病学特点和治疗措施方面的状况及演变，为今后本地区急性心肌梗死的治疗提供资料。方法对胶南市4家市级医院1992、1997、2002年3个全年段急性心肌梗死住院病历进行回顾性分析和比较。结果共调查急性心肌梗死病人190例，其中男性占64．2％，男性多于女性（x^2=10．33，P〈0．01），10年内平均年龄由（58．1±10．3）岁上升到（66．4±10．1）岁（F=4．86，q=5．34，P〈0．05）。1992、1997、2002年住院天数分别为（27．8±34．1）、（19．2±11．7）、（13．7±11．7）d，逐年缩短（F=6．72，q=4．23～5．52，P〈0．01）；发病至入院时间由（29．0±24．7）h缩短为（11．3±13．6）h（F=6．13，q=5．67，P〈0．01）。住院期间病死率呈逐年下降趋势，3个年度分别为43．1％、26．2％和16．6％（x^2=18．92、10．34，P〈0．01）。住院期间超声心动图检查率分别为11．8％、20．6％和27．4％。抗血小板和抗凝药物、β受体阻滞剂、血管紧张素转换酶抑制剂及降脂药物的使用率呈逐年增多的趋势，钙离子拮抗剂使用率有逐年下降的趋势。2002年度溶栓治疗使用率为18．4％，行急诊PTCA及支架置入术1例。结论10年来急性心肌梗死治疗手段取得了很大进步，积极把这些治疗手段应用于临床实践十分重要。

Objective To investigate the epidemiology and treatment of in patients with acute myocardial infarction （AMI） in the years of 1992, 1997 and 2002 in Jiaonan city, and to provide information on treatment of AMI in this area. Methods Data of AMI patients hospitalized in 1992, 1997 and 2002 of four city-level hospitals in Jiaonan were analyzed and compared. Resuits A total of 190 patients were investigated. The majority （64.2%） were males and the average age of the onset was from 58.1±10.3 years to 66.4±10.1 years （F=4.86,q=5.34,P〈0.05）. Hospital-stay days were 27.8±34.1, 19.2±11.7, and 13.7±11.7 （F=6.72,q=4.23-5.52, P〈0.01）, for 1992, 1997, and 2002, respectively. The mortality decreased dramatically from 43.1% in 1992, 26.2% in 1997 to 16.6% in 2002 （x^2=18.92,10.34, P〈0.01）. UCG examination increased year by year, being 11.8%, 20.6%, and 27.4%, respectively. The use of β-blocker, ACEI, antiplatelet agents and lipid-lowering drug increased, and the patients receiving calcium antagonists decreased in recent 10 years. The patients receiving thrombolytic treatment was 18.4%, and acute PTCA done in one case in 2002. Conclusion A great progress for AMI therapy has been made in the past ten years. It is important to apply it in clinical practice.