北京市急性心肌梗死患者危险因素的分布及知晓情况调查

Prevalence and Knowledge of Cardiovascular Risk Factors in Patients with Acute ST elevation Myocardial Infarction

目的:调查北京市急性ST段抬高心肌梗死(STEMI)患者的心血管危险因素分布、控制和知晓情况,以及影响危险因素认知的因素。方法:入选北京市19家二级和三级医院在2006年1～7月期间在发病后24小时内到达医院的430例STEMI患者。收集人口统计学资料、危险因素和控制情况、病史和临床情况。在入院后72小时内内通过问卷调查了解患者对血管疾病危险因素的知晓情况,用Logistic回归分析影响心血管危险因素知晓的因素。结果:430例患者的年龄中位数为62岁(53～72岁),早发心肌梗死(男性＜55岁,女性＜65岁)的比例为34%,存在的危险因素个数平均为(3．0±1．4)个,≥13种危险因素的患者占64．4%。在可纠正的危险因素中,高血压的患病率最高(47．9%,95% CI 43．2%～52．6%),其次为吸烟(46．5%,95% CI 41．8%～51．2%)和缺乏运动(40%,95% CI 35．4%～44．6%),患糖尿病和高脂血症的比例分别为20．7%和17．7%。75．2%的高血压患者正在服药治疗,糖尿病和高脂血症的治疗率仅为10%和40．8%。在问卷调查的9种危险因素中,患者平均知晓(3．0±3．0)种。男性(OR=2．2,95% CI:1．6～3．1,P＜0．001)、高血压(OR:1．5,95% CI, 1．1～1．9,P=0．05)和存在多种危险因素(OR=1．3,95% CI,0．9～2．1,P=0．004)的患者对危险因素的认识较好。结论:北京市2/3的STEMI患者有≥3种的危险因素;对危险因素的知晓率较低;性别、是否存在高血压和存在危险因素的个数对患者的危险因素知晓情况有一定影响。

Objective： Current knowledge of the impact of cardiovascular risk factors in Beijing is limited. This study is to investigate the prevalence and knowledge of cardiovascular risk factors in patients with ST elevation myocardial infarction （STEMI） in Beijing, China.Methods： A hospital - based multicenter, cross - sectional study was conducted between January to July 2006. Patients admitted with their STEMI in 19 hospital in Beijing were eligible to participate. Standard questionnaire was used to interview 430 subjects within 72 hours after admission. Patientss scoring a total greater than or equal to three risk factors were regarded as having a good level of knowledge of CVD risk factors .Results：The median age was 62 years. The premature myocardial infarction was 34% .The patients with STEMI had （3.0 ± 1.4） cardiovascular risk factors. About 64.4% of patients had 3 or more than 3 risk factors. Most common risk factors were hypertension （40%） smoking （46.5%） and lack of exercise （40%） . In multiple logistic regression analysis, independent predictors of good level of knowledge were male （OR = 2.2, 95% CI： 1.6 - 3.1, P 〈 0.001）, hypertension （OR = 1.5, 95% CI： 1.1- 1.9,P = 0.05）and multiple risk factors （OR= 1.3,95% CI： 0.9-2.1, P = 0.004）.Conclusion：More than two thirds of STEMI patients in Beijing have 3 or more than 3 cardiovascular risk factors. Patients have less knowledge about risk factors of CHD, especially in those who were female, non - hypertension and having fewer kinds of risk factors.