某院医师对急性心肌梗死指南中抗栓治疗的依从性分析  

Compliance analysis of antithrombotic therapy in the treatment of acute myocardial infarction for physicians in a hospital

作　　者：何效平[1,2] 何梅[1,2] 黎风 蒲俊 刘福[1,2] HE Xiao-ping;HE Mei;LI Feng;PU Jun;LIU Fu(Department of Pharmacy,The Affiliated Hospital,North Sichuan Medical College,Nanchoing 637000,China;Department of Cardiology,The Affiliated Hospital,North Sichuan Medical College,Nanchoing 637000,China;School of Pharmacy,North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院药剂科,四川南充637000 [2]川北医学院药学院,四川南充637000 [3]川北医学院附属医院心血管内科,四川南充637000

出　　处：《实用医院临床杂志》2018年第1期49-52,共4页Practical Journal of Clinical Medicine

基　　金：2013年川北医学院科研发展计划项目(编号:CBY13-B-QN15)

摘　　要：目的了解急性心肌梗死抗栓治疗的治疗现状。方法纳入2016年1月至2016年12月就诊我院心血管内科的急性心肌梗死患者,按TIMI危险评分将患者分为低危、中危、高危三组按相关指南对纳入患者的治疗措施进行评估。结果共纳入STEMI患者183例、NSTEMI患者144例;阿司匹林负荷剂量、氯吡格雷负荷剂量使用率较低,在高危组尤甚。溶栓剂、GPIIa/IIIb拮抗剂、抗凝剂的使用比例分别为56.25%、62.96%、97.77%,在各危险组间差异无统计学意义。出院后双联抗血小板使用率显著降低,单用阿司匹林或氯吡格雷或不用抗血小板患者比例增加,西洛他唑使用比例也增加。结论该院的抗栓治疗较指南要求仍有较大差距,患者出院后药物依从性也较差,需进一步加强医师对指南的认识及对患者的宣教。To understand the treatment state of acute myocardial infarction.Patients with acute myocardial infarction who were admitted to our hospital from January 2016 to December 2016 were involved in the study.The patients were divided into high-,medium-and low-risk groups according to TIMI risk score.Treatments of the three groups were evaluated according to relative guidelines.Totally,183 STEMI patients and 144 NSTEMI patients were included.The loading dose of aspirin or clopidogrel was found to be low utilization rate,especially in the high-risk group.The proportion of the use of thrombolytic agents,GPIIa/IIIb antagonists and anticoagulants were 56.25%,62.96%and 97.77%,respectively.There was no significant difference among the three groups.Dual antiplatelet use rate was decreased significantly after discharge while aspirin or clopidogrel alone or no antiplatelet agents were increased.In addition,the proportion of cilostazol use was increased.There is still a big gap between the treatment of the hospital and the guidelines.The compliance of the patients after discharge is also poor.Therefore,we need to strengthen the understanding of the guide and the education of the patients.

关 键 词：心肌梗死 指南 依从性 

分 类 号：R541.4[医药卫生—心血管疾病]