我院516例急性心肌梗死患者二级预防药物应用调查与分析

Survey and Analysis on the Use of Secondary Prevention Drugs in 516 Patients with Acute Myocardial Infarction in Our Hospital

目的:为急性心肌梗死患者合理使用二级预防药物提供参考。方法:收集我院心血管内科2013年1月-2015年6月出院的急性心肌梗死患者的病例资料,对抗栓药[阿司匹林、二磷酸腺苷(ADP)受体拮抗药]、调脂药(他汀类药物)、神经内分泌抑制剂[血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗药(ARB)、β受体阻滞药]的使用情况进行分析。结果:共纳入516例患者,排除禁忌证后,药物使用率分别为阿司匹林100%、ADP受体拮抗药100%、他汀类调脂药100%、ACEI/ARB 66.4%、β受体阻滞药85.3%。剂量达标率分别为阿司匹林100%、ADP受体拮抗药98.8%、他汀类调脂药99.4%、ACEI/ARB 82.0%、β受体阻滞药64.8%。共有33例患者出现药品不良反应。结论:我院急性心肌梗死患者抗栓药、调脂药使用较合理,神经内分泌抑制剂的使用仍与指南存在一定差距。

OBJECTIVE：To provide reference for rational use of secondary prevention drugs in patients with acute myocardial infarction. METHODS：The use of the drugs,including antithrombotic drugs（aspirin and ADP receptor antagonist）,lipid-lowering drugs（statins）,neuroendocrine inhibitors（ACEI or ARB and β-blocker） were analyzed with the data taken from the discharged cases with acute myocardial infarction from Jan. 2013 to Jun. 2015. RESULTS：516 cases were enrolled. The utilization rates of aspirin,ADP receptor antagonist,statins,ACEI/ARB and β-blocker were 100%,100%,100%,66.4% and 85.3%. The rates of reaching standard dose were 100%,98.8%,99.4%,82.0% and 64.8%. A total of 33 cases suffered from ADR. CONCLUSIONS：The use of antithrombotic drugs and lipid-lowering drugs are rational relatively in our hospital,but there is still a certain gap between clinical practice and guideline in the use of neuroendocrine inhibitors.