台州地区近10年急性心肌梗死住院治疗模式和结果变化的调查分析  

A survey on care pattern,disease outcomes of patients with acute myocardial infarction in Taizhou during last decade

作　　者：米亚非 王斌[1] 江建军[1] 张云燕[1] 许莎莎[1] 卢先本[1] 葛卫力[1] 

机构地区：[1]温州医科大学附属台州医院心内科,317000

出　　处：《浙江医学》2015年第16期1353-1356,共4页Zhejiang Medical Journal

基　　金：卫生部卫生公益性行业科研专项(201202025);台州市科技计划A类(2013A32031)

摘　　要：目的 调查台州地区近10年急性心肌梗死（AMI）患者的特征、治疗模式和住院转归.方法 采用回归性分析研究台州医院197 AMI患者的住院病历,选取2001年25例、2006年59例、201 1年1 13例AMI患者,其中男137例（69.5％）,女60例（30.5％）,年龄34 ～87（65.40＆#177;11.64）岁.ST段抬高型心肌梗死176例（80.3％）,非ST段抬高型心肌梗死21例（107％）;前壁心肌梗死97例（492％）,下壁心肌梗死56例（28.4％）,后壁心肌梗死13例（6 6％）;吸烟82例（41 6％）,高血压104例（52.8％）,糖尿病34例（17 3％）,有冠心病史27例（137％）.结果 2011年AMI患者血糖、cTnl峰值、入院时CK-MB、CK-MB峰值高于2001、2006年,差异均有统计学意义（均P＜0.05）,2011年AMI患者从发病距入院时间短于2001、2006年（均P＜0.05）.2011年直接经皮冠状动脉介入（PCI）比例高于2001、2006年（均P＜0.05）.2011年院内再发心绞痛、主要不良心血管事件低于2006年（均P＜0.05）.多元logistic回归分析显示,恶性心律失常（OR=114.030,P＜0.01）和院内再发心肌梗死（OR=75.720,P＜0.05）是AMI患者院内死亡的危险因素.结论 本研究反映了台州地区近10年来AMI的趋势及治疗结果.AMI患者直接PCI比例提高,院内再发心绞痛、主要不良心血管事件显著减少.Objective To survey the care pattern, disease outcomes of patients with acute myocardial infarction （AMI） in Taizhou during last decade. Methods The hospital records of 197 patients with AMI admitted from 2001 to 2011 in Taizhou Hospital were retrospectively analyzed. Among 197 selected patients, 25 were admitted in 2001, 59 admitted in 2006 and 113 in 2011, including 137 males（69.5%） and 60 females （30.5%） with mean age of 65.40±11.64 ys. One hundred and seventy-six pa-tients had ST elevation myocardial infarction （ATEMI） （89.3%） and twenty-one 21 had non-STEMI （10.7%）. Anterior wall MI was present in 97 patients （49.2%）, inferior wall MI in 56 patients （28.4%） and lateral wall MI in 13 patients （6.6%）. Eighty two patients （41.6%） were smoker, 104 had hypertension （52.8%）, 34 had diabetes mellitus（17.3%）, Family history of CAD was present in 27 （13.7%） patients, Results The blood glucose levels, peak troponin I value, initial CK-MB value, peak CK-MB value in patients admitted in 2011 were significantly higher than those in 2006 and 2001 （all P〈0.05）. The time from onset to admission in patients admitted in 2011 was significantly shorter than that in 2006 and 2001 （all P〈0.05）. Primary percutaneous coronary intervention （PCI） was increased significantly in 2011 compared with in 2006 and 2001. The in- hospital re-angina and major adverse car- diovascular events were significantly reduced in 2011 compared with 2006（P〈0.05）. Multivariate regression analysis showed that malignant arrhythmia （OR=114.03, P〈0.01 ） and re-infarction （OR= 75.720, P〈0.05） were risk factors for in-hospital mortality. Conclusion This survey shows the changing trends of disease features, care patterns and in-hospital outcome of AMI patients in Taizhou region during the last decade.

关 键 词：急性心肌梗死 再发心绞痛 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]