2001-2011年急性心肌梗死住院患者强化他汀使用情况及其影响因素  

Assessment of intensive statin therapy in hospitalized patients with acute myocardial infarction and its influence factors

作　　者：曲环[1] 

机构地区：[1]北京大学深圳医院心内科,广东省深圳市518036

出　　处：《实用医学杂志》2017年第15期2492-2496,共5页The Journal of Practical Medicine

基　　金：卫生公益性行业科研专项项目(编号:201202025);国家科技支撑计划项目(编号:2013BAI09B01)

摘　　要：目的评价2001-2011年间我院急性心肌梗死(AMI)住院患者强化他汀使用情况及其影响因素。方法调查我院2001、2006和2011年3个特定年份研究病历,提取临床信息。强化他汀治疗定义为通过他汀治疗使低密度脂蛋白胆固醇(LDL-C)预期降低至少40%。结果共计767例接受他汀治疗且有明确剂量的AMI患者病历纳入研究。AMI患者院内强化他汀的使用率从2001年的0%增加到2006年的60.77%和2011年的88.71%(P<0.000 1)。多因素模型中,院内女性患者接受强化他汀治疗率明显低于男性(P=0.015),吸烟患者强化他汀治疗率显著高于高血压、糖尿病和高脂血症患者(P=0.008 1),LDL水平对他汀治疗情况没有显著影响(P=0.106);缺血性脑卒中患者强化他汀治疗率明显低于有心梗病史和冠心病史的患者(P=0.043 7);临床入院状态(胸痛、心源性休克和心脏骤停)不影响是否强化他汀治疗(P>0.05);STEMI患者接受强化他汀治疗率显著低于NSTEMI患者(P<0.000 1)。结论 AMI患者强化他汀治疗率逐年增加,且受性别、危险因素、疾病史和心肌梗死类型的影响。Objective To explore the status quo of intensive statin therapy in hospitalized patients with acute myocardial infarction(AMI)from 2001 to 2011 and analyze its influence factors.Methods We obtained information of AMI patients in 2001,2006,and 2011 from their medical record.Intensive statin therapy was defined as statin regiments with expected LDL-C lowering of at least 40%.Results Among 767 patientswith definite dosage of statin,the use frequencyof intensive statin increased from 0% in 2001 to 60.77% in 2006,and 88.71% in 2011(P<0.0001).Morefemalesreceived intensive statin therapy than males(P=0.015)and the use frequency of intensive statin therapy in smoking patients was obviously more frequent than that in hypertension,diabetes mellitus and hyperlipidemia patients(P=0.0081).The use frequency of intensive statin therapy in patients with ischemic stroke was significantly lower than that in those with AMI or coronary artery disease(P=0.0437).AMI patients with STelevatedwere much less likely received intensive statin therapy than those with non-ST elevated(P<0.0001).Chest pain,cardiac shock or cardiac arrest and the base level of LDL-C exerted no influence on the use of intensive statin therapy(P>0.05).Conclusions The use frequency of intensive stain therapy among AMI patientsincreasesyear by year and it is affected by sex,risk factors,history of disease and type of infarction.

关 键 词：急性心肌梗死 强化他汀治疗 血脂 

分 类 号：R542.22[医药卫生—心血管疾病]