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2006至2012年急性冠状动脉综合征住院患者诊疗状况的变化 被引量:23

Changes in the diagnosis and treatment of hospitalized patients with acute coronary syndrome from 2006 to 2012 in China
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摘要 目的 了解2006至2012年急性冠状动脉综合征(ACS)住院患者诊疗情况的变化.方法 分别于2006年在全国31个省、自治区和直辖市65家医院(中国冠心病二级预防架桥工程Ⅰ期研究)和2012年在全国21个省、自治区和直辖市34家医院(中国冠心病二级预防架桥工程Ⅲ期研究)连续入选≥18岁的住院冠心病患者3323例和3391例.排除因外伤入院并怀疑ACS者及已参加任何一项药物临床试验者.将其中调查资料完整的ACS患者纳入本研究,2次调查的有效病例数均为3 124例.结果 (1)2012年入选患者的年龄小于2006年入选患者的年龄[(61.9±11.2)岁比(64.7±11.5)岁,P<0.01],中青年(≤60岁)患者的比例较2006年入选的患者高[42.5%(1327/3124)比32.1%(1004/3124),P<0.01].(2)2012年入选患者合并高血压[59.3%(1853/3124)比53.0%(1655/3124)]、糖尿病[24.3% (760/3124)比16.4% (513/3124)]、高胆固醇血症[20.3%(633/3124)比6.3%(197/3124)]的比例较2006年入选患者高(P均<0.01).(3)冠状动脉造影检查率由2006年的28.6%(894/3124)增加至2012年的68.6% (2144/3 124)(P<0.01).经皮冠状动脉介入治疗率由2006年的24.6%(770/3 124)增加至2012年的51.0%(1594/3 124)(P<0.01).(4) 2012年入选患者住院期间阿司匹林[95.2% (2975/3124)比91.7% (2864/3124)]、氯吡格雷[85.6%(2673/3124)比42.2%(1318/3124)]和他汀类药物[90.0% (2812/3124)比69.8%(2180/3124)]的使用率均高于2006年入选患者(P均<0.01).结论 与2006年比较,2012年我国ACS住院患者发病年龄年轻化,合并多重危险因素的比例增加,临床诊治水平提高. Objective To observe the changes in the diagnosis and treatment of hospitalized patients with acute coronary syndrome (ACS) from 2006 to 2012 in China.Methods Hospitalized patients with ACS in 2006 from 65 hospitals distributed in 31 provinces,autonomous regions,and municipalities (data derived from the BRIG project phase Ⅰ study,n =3323) and hospitalized in 2012 from 34 hospitals distributed in 21 provinces,autonomous regions,and municipalities (data derived from the BRIG project phase Ⅲ study,n =3 391) were included.Patients with susceptible ACS,patients admitted to hospital due to trauma,or patients participated in any drug clinical trials were excluded.Only patients with complete data were analyzed.Data between 3 124 ACS patients from BRIG project-Ⅰ and 3124 ACS patients from BRIG project-Ⅲ were compared.Results (1) The ACS patients hospitalized in 2012 were younger than those hospitalized in 2006 ((61.9 ± 11.2) years vs.(64.7 ± 11.5) years,P 〈 0.01),and the percentage of patients ≤60 years was higher in patients hospitalized in 2012 ((42.5% (1 327/3 124)) compared with those hospitalized in 2006 (32.1% (1 004/3 124),P 〈 0.05).(2) The percentages of ACS patients complicated with hypertension ((61.2% (1853/3124) vs.53.0% (1 655/3 124)),diabetes (24.3% (760/3124) vs.16.4% (513/3124)),and hypercholesterolemia (20.3% (633/3124) vs.6.3% (197/3124)) were consistently higher in ACS patients hospitalized in 2012 than in hospitalized ACS patients in 2006 (all P 〈 0.01).(3) The rate of coronary angiogram examination increased from 28.6%(894/3 124) in 2006 to 68.6% (2144/3124) in 2012 (P 〈 0.01).Moreover,the rate of intervention treatment was increased from 24.6% (770/3124) in 2006 to 51.0% (1 594/3 124) in 2012(P 〈0.01).(4) The administration rate of aspirin (95.2% (2 975/3 124)vs.91.7% (2 864/3 124)),clopidogrel (85.6% (2673/3124) vs.42.2% (1318/3124)�
出处 《中华心血管病杂志》 CAS CSCD 北大核心 2014年第11期957-962,共6页 Chinese Journal of Cardiology
关键词 冠状动脉疾病 诊断 治疗 Coronary disease Diagnosis Therapy
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