摘要
背景β-受体阻滞剂能显著改善冠心病的临床症状,缓解心绞痛的发生,降低全因死亡率。新疆地区不同民族之间在冠心病病变程度、危险因素等方面存在差异,在两个民族之间,临床用药的不同也应引起重视。目的调查新疆地区维吾尔族和汉族冠心病患者β-受体阻滞剂使用情况及静息心率达标情况,并探讨其影响因素。方法选择2016年12月—2017年3月石河子大学医学院第一附属医院住院的812例冠心病患者,维吾尔族140例(17.24%),汉族672例(82.76%),记录患者入院时一般临床资料,服用β-受体阻滞剂例数,行冠状动脉造影、血运重建的比例,冠状动脉病变支数,记录入院及出院时静息心率,出院时静息心率达标情况。采用多因素Logistic回归分析服用β-受体阻滞剂及静息心率达标的影响因素。随访6个月,记录患者继续服药率及停药原因。结果维吾尔族冠心病患者年龄、出院时静息心率达标率较汉族低,体质指数(BMI)、合并高血压、心肌梗死、心力衰竭比例、低密度脂蛋白水平、冠状动脉造影、血运重建的比例、冠状动脉病变支数、入院和出院时静息心率较汉族升高(P<0.05)。多因素Logistic回归模型结果显示,年龄[OR=8.924,95%CI(5.483,14.525)]、吸烟[OR=2.014,95%CI(1.412,2.873)]、高血压[OR=1.697,95%CI(1.183,2.436)]、心肌梗死[OR=1.418,95%CI(0.994,2.022)]、心力衰竭[OR=1.661,95%CI(1.155,2.388)]、糖尿病[OR=2.175,95%CI(1.497,3.160)]、冠状动脉造影[OR=1.887,95%CI(1.320,2.696)]、血运重建[OR=2.080,95%CI(1.376,3.145)]、冠状动脉病变支数[OR=0.159,95%CI(0.070,0.359)]是服用β-受体阻滞剂的影响因素(P<0.05);年龄[OR=2.069,95%CI(1.173,3.649)]、民族[OR=0.292,95%CI(0.196,0.433)]、心肌梗死[OR=1.918,95%CI(1.357,2.710)]是静息心率达标的影响因素(P<0.05)。随访6个月,维吾尔族和汉族冠心病患者继续服药率分别为89.29%(125/140)、93.78%(618/659)。结论维吾尔族和汉族�
Background Beta blockers can improve clinical symptoms of coronary heart disease(CHD),relieve the incidence of angina pectoris and reduce all-cause mortality in patients.Lesion degree and risk factors of CHD show differences in Uygur and Chinese Han patients.Between two ethnic groups,the difference in clinical medication should also be taken seriously.Objective To investigate the usage of beta blockers and resting heart rate(RHR) controlling status in Uygur and Chinese Han patients with CHD in Xinjiang,and to explore its influencing factors.Methods A total of 812 patients [140 Uyghur(17.24 %) and 672 Chinese Han(82.76 %)],diagnosed with CHD and hospitalized in the First Affiliated Hospital of the Medical College,Shihezi University from December 2016 to March 2017 were enrolled and followed up for six months.Data of general clinical information,coronary arteriography,revascularization,characteristics of coronary lesions,the usage,types and dosage of beta blockers,RHR at admission and discharge,controlling rate of RHR,and the rate of compliance and the causes of the drug withdrawal were collected and recorded.Factors influencing beta blockers-taking compliance and controlling rate of RHR were analyzed with multivariate Logistic regression analysis.Results Compared to Chinese Han patients with CHD,Uygur patients are significantly younger and they displayed larger body mass index(BMI),lower controlling rate of RHR,higher low density lipoprotein level,higher rate of coronary arteriography and revascularization,combined with other diseases including hypertension,heart failure,myocardial infarction and multi-vessel lesion,with higher RHR at admission and discharge(P<0.05).In addition,the results of multivariate Logistic regression analysis showed that age [OR=8.924,95%CI(5.483,14.525)],smoking [OR=2.014,95%CI(1.412,2.873)],hypertension [OR=1.697,95%CI(1.183,2.436)],myocardial infarction [OR=1.418,95%CI(0.994,2.022)],heart failure [OR=1.661,95%CI(1.155,2.388)],diabetes mellitus [OR=2.175,95%CI(1.497,3.160)],coronary angi
作者
梁健
苏欣
刘红阳
徐忠诚
刘稳
王丽
LIANG Jian;SU Xin;LIU Hongyang;XU Zhongcheng;LIU Wen;WANG Li(The Third Department of Cardiology,the First Affiliated Hospital of the Medicine College,Shihezi University,Shihezi 832000,China)
出处
《中国全科医学》
CAS
北大核心
2019年第2期157-161,共5页
Chinese General Practice
基金
石河子大学医学院第一附属医院院级重点课题(TJ2016-001)
关键词
冠心病
肾上腺素能Β受体拮抗剂
维吾尔族
汉族
影响因素分析
Coronary disease
Adrenergic beta-antagonists
Uygur nationality
Han nationality
Root cause analysis
