摘要
目的回顾性评价2001~2011年台州医院急性心肌梗死(AMI)患者的特征、诊疗模式和院内结局方面的变化趋势。方法冠心病医疗结果评价和临床转化研究是一项多中心临床研究,为AMI回顾性研究,台州医院为162家协作医院之一。本研究采用两阶段随机抽样数据设计。选取台州医院有效合格AMI患者197例,其中2001年25例、2006年59例、2011年113例,对3个特定年份患者临床特征、诊疗模式和院内不良心血管事件进行比较。结果 AMI患者以老年、男性(69.5%)、ST段抬高型心肌梗死(89.3%)为特点。直接PCI从2001年的0上升到2011年的50.4%(P〈0.05)。入院24h内应用阿司匹林2001年96.0%,2006年96.6%,2011年97.3%,入院24h内应用氯吡格雷2001年4.0%,2006年96.6%,2011年97.3%、他汀类药物2001年60.0%,2006年96.6%,2011年97.3%(P〈0.05,P〈0.01)。2006年与2011年主要不良心血管事件发生率有统计学差异(50.8%vs31.1%,P〈0.05)。多元logistic回归分析显示,吸烟(OR=0.036,P〈0.05)、Killip分级(OR=2.682,P〈0.05)和院内死亡(OR=177.970,P〈0.05)是AMI患者院内心源性休克的独立危险因素。结论台州地区AMI的发展趋势为,尽管某些治疗措施在过去的10年改善明显,仍需进一步提高医疗质量,改善AMI患者预后。
Objective To assess the characteristics,treatment and diagnosis,and outcome of patients with acute myocardial infarction(AMI)admitted to our hospital from 2001 to 2011.Methods Assessment of medical treatment outcomes and clinical transformation are a multicenter clinical trial.Taizhou Hospital is one of the 162 collaborative hospitals.One hundred and ninety-seven AMI patients(25in 2001,59 in 2006and 113 in 2011)were included in this study by 2-stage cluster sampling.Results AMI patients were characterized by older age,men(69.5%),STEMI(89.3%).The primary PCI was increased from 0%in 2001 to 50.4%in 2011(P〈0.05).The rate of aspirin,clopidogrel and statins used within 24 hafter the patients were admitted was96.0%in 2001 and 97.3%in 2011,4.0%in 2001 and 97.3%in 2011,60.0%in 2001 and 97.3%in 2011,respectively(P〈0.05).Multivariate logistic regression analysis showed that smoking,Killip classification and inhospital mortality were the independent risk factors for cardiogenic shock in AMI patients(OR=0.036,OR=2.682,OR=177.970,P〈0.05).Conclusion Although significant improvement has been achieved with certain measures for the treatment of AMI in the past 10 years,there is still a large room for medical treatment to further improve the outcome of AMI patients.
出处
《中华老年心脑血管病杂志》
CAS
2016年第4期367-371,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
卫生部卫生公益性行业科研专项(201202025)
台州市科技计划A类(2013A32031)
关键词
心肌梗死
阿司匹林
吸烟
冠心病
休克
心原性
myocardial infarction
aspirin
smoking
coronary disease
shock, cardiogenic