急性心肌梗死患者支架术后药物治疗及预后  

The medical treatment and relative outcomes after percutaneous coronary intervention in acute myocardial infarction patients

作　　者：柴仁贵[1] 李文宇[2] 丛洪良[2] 

机构地区：[1]天津医科大学研究生院天津300070 [2]天津市胸科医院

出　　处：《天津医科大学学报》2008年第4期495-497,共3页Journal of Tianjin Medical University

摘　　要：目的:评价急性心肌梗死(AMI)患者直接经皮冠状动脉介入(PCI)支架植入术后药物应用情况及预后。方法:对344例AMI患者直接PCI支架植入术后应用的主要药物进行调查,观察终点事件的发生情况。结果:随访12个月,出院时阿司匹林、氯吡格雷、血管紧张素转换酶抑制剂(ACEI)或血管紧张素II受体拮抗剂(ARB)、他汀类和β受体阻滞剂的服药率分别为99.4%、100.0%、76.7%、98.0%、77.3%,随访12个月时降低到98.8%、77.5%、41.0%、65.4%、64.2%。年龄≤60岁患者ACEI或ARB和β受体阻滞剂的服药率较>60岁者低(P<0.05)。前壁AMI患者ACEI或ARB服药率较下壁AMI高(P<0.05)。12个月时未服用阿司匹林、氯吡格雷者发生终点事件的风险增加(P<0.05)。结论:AMI患者支架术后对药物的依从性良好,前壁AMI患者ACEI或ARB服药率高,PCI术后患者应加强抗血小板治疗。Objective： To investigate the medical treatment in the patients undergoing percutaneous coronary intervention （PCI） and its relative outcomes. Methods：The medical treatment was investigated in 344 patients with acute myocardial infarction （AMI） after PCI, The end-points events was evaluated. The average follow-up time was 12 months. Results：The prescription of aspirin, clopidogrel, ACEI or ARB, statins, beta blocker was 99.4%, 100.0%,76.7%,98.0% and 77.3%at discharge, 98.8%,77.5%,41.0%,65.4% and 64.2% at follow-up 12 months. ACEI or ARB and beta blocker medication rates were lower in patients under the age of 60 （include 60） than over 60 （P〈0.05）, ACEI or ARB medication was high in patients with anterior AMI（P〈0.05）. Cessation the aspirin and clopidogrel therapy increased the end-points events（P〈0.05）. Conclusion：Most patients adhere to the medical treatment during follow-up, ACEI or ARB medication is used highly in patients with anterior AMI, antiplatelet therapy should be strengthened in patients after PCI.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 药物治疗 预后 

分 类 号：R542.22[医药卫生—心血管疾病]