冠心病、2型糖尿病和高血压并发心脑血管事件的回顾性研究

Retrospective study on cardiocerebrovascular incidents of CHD,T2DM and EH

目的对冠心病、2型糖尿病和高血压并发心脑血管事件前后的临床变量关系。方法将冠心病、2型糖尿病和高血压患者418例按年分分为两组,对两组心脑血管事件发生前的各项临床变量和发生后的急救相关时间及病死率进行回顾性对比分析。结果(1)急性心肌梗死(AMI)和急性脑血管疾病(ACVD)的发生率2004年组低于1999年组(P<0.05);(2)在AMI和ACVD发病前有明确诱因及发病时有典型临床表现的患者虽逐年增高(P>0.05),但发病时能识别心脑血管事件报警信号的患者逐年增高更明显(P<0.05);(3)随着两组发生心脑血管事件后的急救相关时间的逐年缩短(P<0.05),病死率呈逐年减少的趋势(P>0.05)。结论三种慢性病患者对心脑血管事件发生的识别能力逐年提高,但现有的医疗服务模式并没有提高慢性病患者的生存率。因此,对发生心脑血管事件患者的急救需要引进有组织的医疗服务模式(胸痛单元及卒中单元)。

Objective To retrospectively study the clinical variance before and after acute cardiocerebrovascular incidents of coronary heart disease （CHD）, type 2 diabetes mellitus （T2DM）and essential hypertension （EH）. Methods 418 cases of CHD, T2MD and EH were yearly divided into two groups to compare the clinical variables before cardiocerebrovascular incidents, first aid correlation time after cardiocerebrovascular incidents and the mortality. Results （1）The incidents of acute myocardial infarction （AMI） and acute cardiovascular disease （ACVD）in group 2004 were lower than those in group 1999 （P 〈 0.05 ）. （2）Though the patients with identified motivation before AMI and ACVD and typical clinical manifestations at onsets were gTadually increased （P 〉 0.05）, the ones with discerned warning signs of cardiocerebrovascular incidents at onsets were gTadually and significantly enhanced （ P 〈 0.05 ）. （3）The first aid correlation time after AMI or ACVD were shortened year by year （ P 〈 0.05 ）, but the mortality of the patients with AMI or ACVD had trend to decrease yearly （ P 〉 0.05 ） in two groups. Conclusions The recognition ability of cardiocerebrovascular incidents of the patients with CHD, T2MD and EH gradually elevate yearly, but the present medicine and health care mode do not increase the survival rate of the patients with chronic diseases. So it is necessary that the organized medical services mode （chest pain unit and strok unit）be introduced to the first aid of patients with cardiocerebrovascular incidents.