冠心病二级预防及危险因素控制情况调查  

Prevalence on secondary prevention and risk factors control for coronary heart disease

作　　者：沈健[1] 罗素新[1] 杨彦鹏[1] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016

出　　处：《中华老年多器官疾病杂志》2013年第3期180-183,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：重庆市卫生局医学科研计划项目（No.2009-2-421）

摘　　要：目的了解冠心病患者二级预防用药现状及其危险因素控制情况，分析其与循证医学指南的差距。方法随机选取2010年5月至2011年2月期间住院并经冠状动脉造影检查确诊为冠心病的患者，调查其出院6个月后主要冠心病药物应用情况及住院时与随访时吸烟、血压、血糖、血脂等危险因素指标的变化。结果共128例患者接受随访。出院时应用阿司匹林、氯吡格雷、B受体阻滞剂、肾素．血管紧张素．醛固酮系统阻断剂及他汀类药物的比例分别为91．41％、97．66％、67．19％、65．63％及97．66％，而随访时上述药物的应用比例分别为87．50％、83．59％、57．03％、57．81％及85．16％。住院及随访时吸烟患者的比例分别为31．25％及6．25％。住院时患者血压达标率为54．69％，而随访时血压达标率上升至75．78％。住院时17．19％的患者合并糖尿病，随访时该比例升至27．27％。随访时分别有78．91％、69．53％及70-31％的患者总胆固醇、甘油三酯及低密度脂蛋白胆固醇达标。结论冠心病患者二级预防用药情况基本理想，多数危险因素控制良好。在现有基础上医务人员应进一步加强对患者冠心病二级预防的宣传教育，缩小与指南要求间的差距。Objective To investigate the secondary prevention and risk factor control in the patients with coronary artery diseases in order to analyze the differences between real world practice and evidence-based guidelines. Methods The patients with coronary angiography-diagnosed coronary heart disease hospitalized in our department during May 2010 to February 2011 were enrolled in this study. Their smoking condition, blood pressure, blood glucose, blood lipids and other risk factors during hospitalization and follow-up, and their medical treatment within 6 months after discharge were studied and analyzed. Results There were totally 128 patients being followed up. At discharge, the percentage of using aspirin, clopidogrel, beta blocker, ACEI/ARB and statins in their prescription was 91.41%, 97.66%, 67.19%, 65.63% and 97.66% respectively, and at the follow-up, the percentage changed to 87.50%, 83.59%, 57.03%, 57.81% and 85.16% respectively. The rate of smoking was decreased from 31.25% in hospitalization to 6.25% at follow-up, while the rate of normal blood pressure was increased from 54.69% in hospitalization to 75.78% at follow-up. The rate of the patients complicated with diabetes mellitus was 17.19% at discharge, and then increased to 27.27% at follow-up. During follow-up, there were 78.91%, 69.53% and 70.31% of the total patients who had normal levels of TC, TG and LDL-C. Conclusion Most patients comply to the medical treatment of secondary prevention during follow-up. And most risk factors are under well control Prompt and effective measures should be taken to enhance medical education for secondary prevention to minimize the gap between clinical practice and evidence-based guidelines.

关 键 词：冠状动脉疾病 药物疗法 危险因素 随访研究 

分 类 号：R541.4[医药卫生—心血管疾病]