新疆地区维吾尔族与汉族冠心病患者经皮冠状动脉介入治疗术后Ⅱ级预防现状分析

Secondary prevention between Uygur and Han patients after percutaneous coronary intervention in Xinjiang

目的了解新疆地区维吾尔族与汉族冠心病患者接受经皮冠状动脉介入治疗(PCI)术后Ⅱ级预防与危险因素的控制情况。方法选取2006年1月至2008年5月在新疆医科大学第一附属医院心脏中心冠心病科住院的维吾尔族与汉族冠心病患者258例,所有患者均接受PCI。其中维吾尔族86例,汉族172例。记录患者住院和随访期间服用阿司匹林(ASA)、β受体阻滞剂(BB)、他汀类药物、血管紧张素转换酶抑制剂(ACEI)等药物,以及吸烟、高血压、糖尿病、超重、血脂等危险因素情况。随访中记录主要心血管不良事件(死亡、AMI、再次血运重建、脑卒中)发生情况。结果住院期间ASA,BB、他汀类药物和ACEI使用率维吾尔族患者分别为98.8%、67.4%、97.6%、59.3%,而汉族药物使用率分别由98.8%、65.1%、98.2%、62.2%。随访期间药物的使用率均显著低于住院期间(P<0.005),在ASA、ACEI、β受体阻滞剂、他汀类降脂药物的应用率维吾尔族患者随访时降低到84.8%、47.6%、55.8%、36.0%,而汉族药物使用率降低到87.2%、48.8%、64.5%、45.3%。维吾尔族与汉族患者在超重与脂代谢紊乱危险因素存在差异(P<0.05),维吾尔族与汉族在主要心血管不良事件无差异(P<0.05)。结论冠心病患者接受血运重建后,维吾尔族与汉族住院期间Ⅱ级预防药物治疗使用率均较高,随访期间药物使用率显著降低。维吾尔族在超重及脂代谢紊乱等危险因素与汉族存在差异,应加强维吾尔族冠心病患者Ⅱ级预防。

Objective To evaluate the status of the secondary prevention and risk factors after percutaneous coronary intervention（PCI）in the Uygur and Han populations with coronary artery disease（CAD） in Xinjiang. Methods Two hundred and fifty eight CAD patienfs included 86 Uygur receiving PCI during July 2006 to May 2008 were registered fore the First Affiliated Hospital, Xinjiang Univesrity. The use of medicines [aspirin,β blocker（BB）, statins, angiotension converting enzyrne inhibitor（ACEI）] and the risk factors including smoking, body weight, blood pressure,fasting blood sugar and lipid levels during hospitalization and during the follow up were recorded. Results The prescription rates of aspirin, BB, statins, and ACEI in Uygur were 98.8%,67.4%,97.6% and 59.3%. The prescription rates of these drugs in Han were 98.8% ,65.1% ,98.2% and 62.2%. The prescription rates of these drugs during follow up were 84. 8%,47.6%,55.8% and 36. 0% in Uygur,and 87. 2%,48. 8%,64. 5% and 45.3% in Han, all were significantly lower than those during hospitalization（all P〈0. 005）. The risk factors of body weight and lipid levels were all higher in Uygur compared with those in Han （all P〈0.05）. Conclusion The CAD patients both Han and Uygur populations re ceiving PCI showed a high proportion of using secondary prevention drugs during hospitalization and the prescription rates of these drugs decrease during follow up. The risk factors of body weight and lipid levels in Uygur were higher than those in Han.