南阳地区某医院急性心肌梗死患者院内用药10年变化趋势

doi:10.6040/j.issn.1671-7554.0.2016.1552

摘要/Abstract

摘要： 目的通过对2001~2011年南阳市中心医院急性心肌梗死(AMI)患者的院内用药分析,探讨10年间AMI患者院内用药的变化趋势,为AMI患者合理用药提供参考。方法随机选择该院2001、2006、2011年间AMI患者住院病历,提取详细临床信息,分析AMI患者阿司匹林、氯吡格雷、他汀、血管紧张素转换酶抑制剂(ACEI)/血管紧张素受体桔杭药(ARB)及β受体阻滞剂的使用情况及其变化趋势。结果共收集AMI病历234份,结果显示:2001~2011年,阿司匹林、氯吡格雷及他汀的应用率增加,差异具有统计学意义(阿司匹林:2001年80.0%,2006年86.0%,2011年94.8%, P=0.013;氯吡格雷2001年0.0%,2006年50.9%,2011年87.8%, P<0.001;他汀2001年34.0%,2006年81.8%,2011年95.6%, P<0.001),β受体阻滞剂和ACEI/ARB类药物应用率仍比较低,且10年间变化无统计学差异(β阻滞剂 2001年51.1%,2006年64.7%,2011年56.4%, P=0.401;ACEI类药物2001年62.5%,2006年72.2%,2011年60.9%, P=0.262)。结论过去10年间,南阳市中心医院AMI患者,阿司匹林、氯吡格雷及他汀使用率明显增加,β受体阻滞剂和ACEI/ARB类药物的使用仍与指南存在一定差距。

关键词: 治疗结果, 他汀, 抗血小板药物, ACEI/ARB类药物, β受体阻滞剂, 心肌梗死

Abstract: Objective To analyze the trend of drug use for inpatients with acute myocardial infarction(AMI)from 2001 to 2011, in order to provide reference for the rational use of drugs. Methods The medical records of inpatients in the year 2001, 2006 and 2011 were reviewed. The uses of aspirin, clopidogrel, stain, β blocker and angiotensin-converting-enzyme inhibitors(ACEI)/angiotensin receptor blockers(ARB)were assessed. Results A total of 234 cases were enrolled. There were significant increases in the use of aspirin(80.0%, 86.0%, 94.8%, P=0.013), clopidogrel(0%, 50.9%, 87.8%, P<0.001), and stain(34.0%, 81.8%, 95.6 %, P<0.001)in 2001, 2006 and 2011. The utilization rates of β blocker(51.1%, 64.7%, 56.4%, P=0.401)and ACEI/ARB(62.5%, 72.2%, 60.9%, P=0.262)were still relatively low, with no statistical difference in the past decade. Conclusion During the past decade, the uses of aspirin, clopidogrel and stain are significantly increased in Nanyang Central Hospital, but there is still gap between clinical practice and guideline in the uses of β blocker and ACEI/ARB.

Key words: Myocardial infraction, Treatment outcome, Stain, Antiplatelet, Angiotensin-converting-enzyme inhibitor/Angiotensin receptor blockers, β-blockers

中图分类号:

R542

高建步,杨守忠,李玉东,乔崇,张松雨. 南阳地区某医院急性心肌梗死患者院内用药10年变化趋势[J]. 山东大学学报（医学版）, 2017, 55(5): 66-69.

GAO Jianbu, YANG Shouzhong, LI Yudong, QIAO Chong, ZHANG Songyu. Trend survey of inpatient use of drugs for acute myocardial infarction during 10 years in a hospital of Nanyang City[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 66-69.

参考文献

[1] 杨艳敏, 朱俊, 谭慧琼, 等. 中国ST段抬高的急性心肌梗死临床特征及治疗现状[J]. 中华医学杂志, 2005, 85(31): 2176-2182. YANG Yanmin, ZHU Jun, TAN Huiqiong, et al. Clinical characteristics and management of patients with ST segment elevation myocardial infarction in China: survey of 7510 cases[J]. National Medical Journal of China, 2005, 85(31): 2176-2182.
[2] 刘红旭, 高伟, 赵东, 等. 北京地区13家中、西医医院急性心肌梗死患者治疗状况调查[J]. 中华心血管病杂志, 2010, 38(4): 306-310. LIU Hongxu, GAO Wei, ZHAO Dong, et al. Survey on the hospitalization treatment status of acute myocardial infarction patients in 13 hospitals of western medicine and traditional Chinese medicine in Beijing[J]. Chinese Journal of Cardiology, 2010, 38(4): 306-310.
[3] Dharmarajan K, Li J, Li X, et al. The China Patient-Centered Evaluative Assessment of Cardiac Events(China PEACE)Retrospective Study of Acute Myocardial Infarction: study design[J]. Circ Cardiovasc Qual Outcomes, 2013, 6(6): 732-740.
[4] 中华医学会心血管病学分会, 中华心血管病学杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2015, 43(5): 380-393.
[5] 中华医学会心血管病学分会, 中华心血管病学杂志编辑委员会. 非ST段抬高急性冠状动脉综合征诊断和治疗指南[J]. 中华心血管病杂志, 2012, 40(5): 353-367.
[6] 中华医学会心血管病学分会, 中华心血管病学杂志编辑委员会. 抗血小板治疗中国专家共识[J]. 中华心血管病杂志, 2013, 41(3): 183-194.
[7] 霍勇, 葛均波, 韩雅玲, 等. 急性冠状动脉综合征患者强化他汀治疗专家共识[J]. 中国介入心脏病学杂志, 2014, 22(1): 4-6.
[8] Larsen AI, Tomey MI, Mehran R, et al. Comparison of outcomes in patients with ST-segment elevation myocardial infarction discharged on versus not on statin therapy(from the harmonizing outcomes with revascularization and stents in acute myocardial infarction trial)[J]. Am J Cardiol, 2014, 113(8): 1273-1279.
[9] Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the american college of cardiology/american heart association task force on practice guidelines[J]. J Am Coll Cardiol, 2014, 63(25PtB): 2889-2934.
[10] OGara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the american college of cardiology foundation/american heart association task force on practice guidelines[J]. Circulation, 2013, 127(4): e362-425.
[11] Li J, Li X, Wang Q, et al. ST-segment elevation myocardial infarction in China from 2001 to 2011(the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data[J]. Lancet, 2015, 385(9966): 441-451.
[12] Pfeffer MA, McMurray JJ, Velazquez EJ, et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both[J]. N Engl J Med, 2003, 349(20): 1893-1906.
[13] 中华医学会心血管病学分会, 中华心血管病学杂志编辑委员会. β肾上腺素能受体阻滞剂在心血管疾病应用专家共识[J]. 中华心血管病杂志, 2009, 37(3): 195-209. Chinese Society of Cardiology of Chinese Medical Association Editorial Board of Chinese Journal of Cardiology Expert consensus document on appropriate use of beta-adrenergic receptor blocker in patients with cardiovascular diseases[J]. Chin J Cardiol, 2009, 37(3): 195-209.
[14] Bainey KR, Armstrong PW, Fonarow GC, et al. Use of renin-angiotensin system blockers in acute coronary syndromes: findings from Get With the Guidelines-Coronary Artery Disease Program[J]. Circ Cardiovasc Qual Outcomes, 2014, 7(2): 227-235.
[15] Park KL, Goldberg RJ, Anderson FA, et al. Beta-blocker Use in ST-segment elevation myocardial infarction in the reperfusion Era(GRACE)[J]. Am J Med, 2014, 127(6): 503-511.
[16] 郭素峡, 羊镇宇, 吴丁烨, 等.无锡地区急性心肌梗死治疗现状调查[J]. 中华心血管病杂志, 2014, 42(4): 309-313. GUO Suxia, YANG Zhenyu, WU Dinghua, et al. A multi-center survey on the therapeutic status of patients with acute myocardial infarction in Wuxi city of China[J]. Chin J Cardiol, 2014, 42(4): 309-313.
[17] 谭静, 华琦. 急性心肌梗死患者血清炎性因子水平及二级预防状况的随访观察[J]. 首都医科大学学报, 2013, 34(3): 437-440. TANG Jing, HUA Qi. A cohort study on the levels of serum inflammatory factors and secondary prevention in patients with acute ST segment elevation myocardial infarction[J]. Journal of Capital Medical University, 2013, 34(3): 437-440.
[18] Wang M, Moran AE, Liu J, et al. Cost-effectiveness of optimal use of acute myocardial infarction treatments and impact on coronary heart disease mortality in china[J]. Circ Cardiovasc Qual Outcomes, 2014, 7(1): 78-85.
[19] Du X, Gao R, Turnbull F, et al. Hospital quality improvement initiative for patients with acute coronary syndromes in China:a cluster randomized, controlled trial[J]. Circ Cardiovasc Qual Outcomes, 2014, 7(2): 217-226.
[20] Ranasinghe I, Rong Y, Du X, et al. System barriers to the evidence-based care of acute coronary syndrome patients in China: qualitative analysis[J]. Circ Cardiovasc Qual Outcomes, 2014, 7(2): 209-216.
[21] The Lancet. Chinese doctors are under threat[J]. Lancet, 2010, 376(9742): 657.

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