真实世界生脉注射液治疗心肌梗死人群的临床特征及优效用药方案分析  

Analysis of clinical characteristics and optimal drug regimen of Shengmai injection in the treatment of myocardial infarction in the real world

作　　者：张强 孙春全 王志飞[1] 谢雁鸣[1] 侯恒悦 Zhang Qiang;Sun Chunquan;Wang Zhifei;Xie Yanming;Hou Hengyue(Institute of Basic Research In Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;不详)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国人民大学统计学院,北京100872

出　　处：《中国循证心血管医学杂志》2023年第6期651-656,共6页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：科技创新工程重大攻关项目(CI2021A00702);国家重点研发计划项目(2018YFC1707410)。

摘　　要：目的对真实世界生脉注射液治疗心肌梗死人群的临床特征及优效用药方案分析。方法使用中国中医科学院中医临床基础医学研究所构建的医院信息系统(HIS)集成数据仓库中24家大型三甲医院2001年1月至2016年12月HIS数据,对1848例使用生脉注射液治疗心肌梗死的患者信息及用药进行统计分析。采用SAS 9.4软件对患者一般信息统计分析。通过Apriori算法构建合并药物关联模型,运用Clementine12.0软件分析。结果心肌梗死患者中男性多于女性,平均年龄为(70.87±13.64)岁,平均住院时间(22.43±18.52)d,平均用药天数为(4.17±10.13)d,以冬春季节发病较多,治愈及好转人数1208例(65.37%)。合并用药中生脉注射液最常见的中药组合是速效救心丸,最常见的西药组合是单硝酸异山梨酯、乙酰水杨酸,合并心力衰竭可使用硝酸异山梨酯,呋塞米,螺内酯;合并心律失常可使用乙酰水杨酸、美托洛尔;频发心绞痛可选择乙酰水杨酸,氯吡格雷。结论真实世界心肌梗死人群多见于中老年男性,心肌梗死后常有合并疾病,可联合使用生脉注射液治疗,疗效较为满意。Objective The objective of this study was to analyze the clinical characteristics and optimal drug regimen of Shengmai injection in the treatment of myocardial infarction in the real world.Methods The study utilized data from the hospital information system(HIS)integrated data warehouse developed by the Institute of Basic Research In Clinical Medicine,China Academy of Chinese Medical Sciences.The HIS data from January 2001 to December 2016 from 24 large tertiary hospitals were analyzed.A total of 1848 patients who received Shengmai injections for the treatment of myocardial infarction were included.Statistical analysis was performed using SAS 9.4 software to analyze patient information and medication patterns.Then,the combined drug association model was constructed by Apriori algorithm and analyzed by Clementine 12.0 software.Results The study found that there were more male patients than female patients with myocardial infarction.The average age of the patients was(70.87±13.64)years,and the average length of hospital stay was(22.43±18.52)days.The average duration of medication was(4.17±10.13)days.Myocardial infarction cases were more common in the winter and spring seasons.A total of 1208 cases(65.37%)showed improvement or cure.The most common combination of traditional Chinese medicine with Shengmai injection was Suxiao Jiuxin Pill.The most common combination of Western medicine included isosorbide mononitrate and acetylsalicylic acid.For patients with heart failure,isosorbide nitrate,furosemide,and spironolactone were commonly used.Acetylsalicylic acid and metoprolol were used for patients with arrhythmia,while acetylsalicylic acid and clopidogrel were used for those with frequent angina pectoris.Conclusion In the real-world setting,myocardial infarction is more common in middle-aged and elderly men,often with comorbidities.The combination treatment with Shengmai injection showed satisfactory therapeutic efficacy.

关 键 词：生脉注射液 心肌梗死 真实世界研究 电子病历数据 

分 类 号：R542.22[医药卫生—心血管疾病]