摘要
目的了解2006、2011年2年福建省急性心肌梗死(AMI)患者住院早期氯吡格雷的使用情况,并探讨其影响因素。方法基于"冠状动脉性心脏病医疗结果评价和临床转化研究-回顾性急性心肌梗死研究"所收集的2006和2011年2年福建省AMI患者的临床信息,评估住院早期(入院24h内)氯吡格雷的应用情况,并采用Logistic回归方法分析其使用的影响因素。结果共纳入无氯吡格雷禁忌证患者490例,年龄中位数为58.4岁,女性130例,占26.5%。2006年和2011年,住院早期氯吡格雷使用率分别为19.5%和80.5%(P<0.01),2006年再灌注策略中直接经皮冠状动脉介入治疗(PCI)患者倾向早期使用氯吡格雷(P<0.01),无再灌注策略患者倾向早期不用氯吡格雷(P<0.01),而溶栓对氯吡格雷的使用无影响。2011年女性患者倾向于早期不用氯吡格雷(P<0.05)。Logistic回归分析结果显示,2006年,接受直接PCI患者更倾向于早期使用氯吡格雷(OR=11.52,95%CI1.70~77.93),而有缺血性脑卒中及年龄分组中65~74岁组的患者倾向于早期不使用氯吡格雷(OR=0.47,95%CI0.24~0.92;OR=0.38,95%CI 0.19~0.76),2011年女性患者倾向于早期不使用氯吡格雷(OR=0.04,95%CI0.19~0.91)。结论 2011年福建省AMI患者药物治疗中氯吡咯雷使用率较2006年提高,老年,女性及无再灌注治疗的患者使用率仍较低。
Objective To evaluate the status of early clopidogrel therapy in acute myocardial infarction(AMI)patients in Fujian province in 2006 and 2011,and to identify factors affecting the use of early clopidogrel. Methods Based on China Patient-Centered Evaluative Assessment of Cardiac Events(China PEACE)study,clinical information of AMI patients in 2006 and in 2011 were collected and status of early clopidogrel therapy(defined as initiated within 24 hours of hospital admission)was analyzed. Logistic regression analysis was used to identify factors affecting the use of early clopidogrel. Results A total of 490 patients were included with a median age of 58.4 years old and with a 26.5%of female. In 2006 and 2011,usage rate of early clopidogrel changed from 19.5%to 80.5%(P<0.01). The early clopidogrel use in patients with thrombolysis in 2006 was not statistically significant(P>0.05). Logistic regression analysis showed that in 2006 patients with direct percutaneous coronary intervention(PCI)were more likely to be treated with early clopidogrel(OR=11.52,95% CI 1.70-77.93),patients with ischemic stroke(OR=0.47,95%CI0.24-0.92)and 65-74 years old(OR=0.38,95%CI0.19-0.76)were less likely to be treated with early clopidogrel;and in 2011 females was less likely to use early clopidogrel.Conclusion Although the use of early clopidogrel in patients with AMI has increased substantially in Fujian province from 2006 to 2011,there has been much less adoption in the patients of elderly,female and patients without reperfusion therapy.
作者
刘春霞
陈祖医
林静
林绍成
严丽丽
金乐梅
苏友福
陈花
林清飞
LIU Chun-xia;CHEN Zu-yi;LIN Jing;LIN Shao-cheng;YAN Li-li;JIN Le-mei;SU You-fu;CHEN Hua;LIN Qing-fei(Department of Cardiology,Wuyishan Municipal Hospital,Wuyishan Fujian 354300,China)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2018年第11期1054-1059,共6页
Chinese Journal of Hypertension
基金
卫生公益性行业科研专项“冠心病医疗结果评价研究和临床转化研究”(201202025)
国家科技支撑计划项目“冠心病医疗质量改善研究”(2013BAI09B01)
关键词
急性心肌梗死
氯吡格雷
影响因素
acute myocardial infarction
clopidogrel
influencing factors
