急性心肌梗死患者PCI术后应用“生命网”药物管理的意义

Significance of heart care network used for drug administration after percutaneous coronary intervention in patients with acute myocardial infarction

目的评价急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后"生命网"药物管理的意义。方法应用"生命网"对562例急性STEMI患者直接PCI术后出院时、6个月末、12个月末的主要药物进行调查,观察终点事件的发生情况。结果术后随访12个月末,阿司匹林、硫酸氢氯吡格雷、他汀类、血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)、β受体阻滞剂的服药率分别为90.6%(509/562)、86.4%(486/562)、70.2%(395/562)、78.8%(443/562)、75.4%(424/562),均较出院时下降(均P<0.05)。12个月末仍服用阿司匹林、氯吡格雷、他汀类药物患者与未服药者相比发生终点事件的风险差异有统计学意义(p<0.05);服用或未服用ACEI或ARB、β受体阻滞剂与发生终点事件的差异无统计学意义(P>0.05)。结论 PCI术后患者必须重视规范化药物治疗,"生命网"有利于患者术后管理。

Objective To evaluate significance of heart care network （HCN） used for drug administration after percutaneous coronary intervention （PCI） in patients with acute ST elevation myocardial infarction （STEMI）. Methods Drug usage was investigated by HCN at discharge, 6 months and 12 months after discharge in 562 patients with STEMI undergoing primary PCI. Endpoint events were recorded. Results The prescription rate of asprin, clopidogrel, statin, angiotensin converting enzyme inhibitors （ACEI）, angiotensin II receptor blocker （ARB） and beta- receptor blocker decreased to 90.6%, 86.4%, 70.2%, 78.8%and 75.4%, respectively, at 12 months, and was significantly lower than that at discharge （P〈0.05）. The incidence of endpoint events was significantly different between those taking and not taking aspirin, clopitogrel and statin （P〈0.05）, but not between those taking and not taking ACEI or ARB and β- receptor blocker. Conclusion It must be emphasized that the patients should take medications regularly after PCI. Heart care network is useful in management of patients after PCI.