80岁以上冠心病患者二级预防及危险因素控制现状  

Status of Secondary Prevention and Control of Risk Factors in Elderly Patients With Coronary Heart Disease in Guangzhou

作　　者：冯国飞[1] 袁慧[1] 纪禹同 谢志泉[1] 陈颖仪[2] 孙宁宁[3] 徐加加[4] FENG Guo-fei;YUAN Hui;JI Yu-tong;XIE Zhi-quan;CHEN Ying-yi;SUN Ning-ning;XU Jia-jia(Department of Geriatric Cardiology,General Hospital of Guangzhou Military Area Command,Guangzhou（510010）,Guangdong,China)

机构地区：[1]广州军区广州总医院老年心血管科,广东省广州市510010 [2]广州医科大学 [3]广州中医药大学 [4]广东药科大学

出　　处：《中国循环杂志》2018年第11期1069-1074,共6页Chinese Circulation Journal

基　　金：广州市健康医疗协同创新重大专项计划(201508020253)

摘　　要：目的:研究调查广州市80岁以上冠心病患者二级预防及危险因素控制现状。方法:对2016-03-05在我院体检的80岁以上冠心病患者进行横断面调查,共收集有效调查表752份(752例)。调查表内容包括基本情况、合并症、体重、血压、血脂、血糖水平及二级预防用药物使用情况等。结果:(1)用药情况:752例患者抗血小板聚集药物、β受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)类药物的服药率分别为55.72%(419例)、30.98%(233例)、25.13%(189例)、42.69%(321例);没有使用二级预防药物的患者占21.94%(165例);仅4.92%(37例)联合使用以上四种药物;(2)血压、空腹血糖、餐后2小时血糖、体重指数达标率分别为81.17%(470/579)、77.61%(253/326)、55.21%(180/326)、54.73%(266/486),以低密度脂蛋白胆固醇<1.8 mmol/L为达标标准,达标率为14.06%(63/448)。结论:该调查人群中,指南推荐的四类药物使用率均较低,与指南要求差距较大,且危险因素达标情况不理想,如何提高二级预防合理用药,使指南与临床实践紧密结合,并且进一步控制危险因素降低冠心病复发率已成为广大医务工作者的重要任务。Objectives： To investigate the status of secondary prevention, treatment and risk factors of retired elderly patients （ 1〉 80 years old） with coronary heart disease in Guangzhou. Methods： A total of 752 questionnaires were collected from the elderly patients with coronary heart disease who underwent routine cardiovascular checkup in our hospital from March to May in 2016. The questionnaire included basic situation, complications, weight, blood pressure, low density lipoprotein, glucose level and secondary prevention medications based on evidence-based medicine. Results： Antiplatelet drugs, beta blockers, statins, ACEI/ARB use rate was 55.72%, 30.98%, 25.13%, 42.69% for the secondary prevention; 21.94% patients did not take secondary prevention drugs, the combined use rate of the four drugs was 4.92%. In elderly patients with coronary heart disease, the control rate of blood pressure （〈150/90 mmHg）, fasting blood glucose （〈7mmol/L）, 2-hour postprandial blood glucose （〈 10 mmol/L）, body mass index （〈24 kg/m2） were 81.17% （470/579 cases）, 77.61% （253/326 cases）, 55.21% （180/326 cases） and 54.73% （266/486 cases）, respectively. With LDL-C〈1.8 mmol/L as the standard, percent with normal LDL-C value was 14.06% （63/448 cases）. Conclusions： In this survey population, use rate of the four types of drugs for secondary prevention and the control rate of known risk factors for coronary artery disease are very low. Efforts are needed to improve rational use of the secondary prevention drugs, minimize the gaps between promote the guidelines and clinical practice, and reduce the recurrence rate of coronary heart disease in elderly patients with coronary artery disease.

关 键 词：老年 冠心病 二级预防 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]