重庆市1010例急性心肌梗死住院治疗状况分析

A retrospective survey of treatment status of 1 010 patients with acute myocardial infarction in Chongqing

目的调查分析重庆地区急性心肌梗死(AMI)一般情况和临床治疗状况。方法回顾分析重庆市1 010例AMI住院病历,记录其一般情况、病史特征、诊断、治疗方式及药物使用情况。结果行经皮冠状动脉介入治疗(PCI)325例,占32.2%,直接PCI 91例,占9.0%,药物溶栓治疗122例,占12.1%;药物使用:肝素/低分子肝素86.6%,他汀类80.8%,硝酸酯类76.7%,阿司匹林90.1%,阿司匹林联用氯吡格雷74.7%,ACEI/ARB 74.2%,β受体阻滞剂55.1%;逐年比较,他汀类、阿司匹林、阿司匹林联用氯吡格雷及肝素/低分子肝素使用率有提高,ACEI/ARB和β受体阻滞剂的实际/适宜使用率呈增加趋势。结论重庆地区AMI早期再灌注治疗及药物治疗距《急性心肌梗死诊断和治疗指南》要求尚有差距。

Objective To document knowledge about the clinical characteristics and management of the patients with acute myo cardial infarction（AMI） in Chongqing. Methods The retrospective survey of 1 010 hospitalized patients with AMI in Chongqing was carried out. All the baseline data, medical history, diagnosis, treatment and drug use characteristics were collected and analyzed. Results Among these patients,32.2% underwent percutaneous coronary intervention （PCI）, 9.0% underwent Primary PCI, and 12.1% received thrombolytic therapy. The rates of various medication employed in the 1 010 patients were： unfractionated heparin / LMWH 86.6 %, statins 80.8% , nitrates 76. 7 %, aspirin 90.1%, aspirin plus clopidogrel 74.7% , ACEI/ARB 74. 2 %,β-receptor blocker 55.1% . The utilization rates of statins,aspirin,aspirin plus clopidogrel and unfractionated heparin/LMWH were increased. The actual utilization to eligible utilization ratio of ACEI/ARB andβ-receptor blocker was increased. Conclusion There still exists a gap between earlier reper;usion treatment and drug therapy on AMI and guidelines in Chongqing.