[北京13家中西医结合医院急性心肌梗死患者住院治疗状况调查]

[Survey on the hospitalization treatment status of acute myocardial infarction patients in 13 hospitals of western medicine and traditional Chinese medicine in Beijing].

作者信息

Liu Hong-xu, Gao Wei, Zhao Dong, Shang Ju-ju

机构信息

Department of Cardiology, Beijing Traditional Chinese Medicine Hospital, Capital Medical University of Science, Beijing 100010, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Apr;38(4):306-10.

PMID:20654073

Abstract

OBJECTIVE

To survey the treatment status and clinical features of hospitalized patients with acute myocardial infarction (AMI) of 13 hospitals in Beijing in 2005.

METHODS

Uniform questionnaires were used to register AMI patients hospitalized from January 1 to December 31, 2005 in the 13 hospitals including traditional Chinese medicine (TCM) hospitals (n = 6) and western medicine hospitals (WM, n = 7) from Beijing. A total of 1663 AMI patients were registered (1366 cases in WM hospitals and 297 cases in TCM hospitals). An Access database was established and patient information was input, the clinical features and treatment status of hospitalized AMI patients were analyzed.

RESULTS

The mean age was (63.9 +/- 12.8) years old [(62.8 +/- 12.8) years for WM Hospitals and (69.1 +/- 11.8) years for TCM hospitals, P < 0.05], male to female ratio was 2.4:1 (2.7:1 for WM hospitals and 1.6:1 for TCM hospitals, P < 0.05). The median time to hospital was 14 hours in TCM hospitals and 11 hours in WM hospitals (P > 0.05). Incidences of history of cerebrovascular disease, high blood pressure, diabetes, hyperlipidemia and complications such as in-patient arrhythmia, cardiac insufficiency, cardiogenic shock were significantly higher in TCM hospitals than in WM hospitals. The total mortality of 1663 AMI cases was 8.2% (15.8% in TCM hospitals vs. 6.6% in WM hospitals, P < 0.01). The reperfusion rate including emergency PCI and thrombolytic therapy rate was 31.3% in 13 hospitals (33.3% in WM hospitals vs. 21.9% in TCM hospitals, P < 0.05). Percent of guideline recommend drug use for AMI was as follows: aspirin 93.6%, ACEI and ARB 85.1%, beta-blocker 78.7%, low molecular weight heparin 85.4%, statins 74.7%.

CONCLUSIONS

Reperfusion therapy and guideline recommended drugs were widely used although there was a need for further improvement. The hospitalized mortality showed a downward trend compared with results from five years ago, patients in TCM hospitals had an independent clinical features.

摘要

目的

调查2005年北京13家医院急性心肌梗死（AMI）住院患者的治疗现状及临床特征。

方法

采用统一问卷对2005年1月1日至12月31日在北京13家医院（包括6家中医院和7家西医院）住院的AMI患者进行登记。共登记1663例AMI患者（西医院1366例，中医院297例）。建立Access数据库并录入患者信息，分析AMI住院患者的临床特征及治疗现状。

结果

平均年龄为（63.9±12.8）岁[西医院为（62.8±12.8）岁，中医院为（69.1±11.8）岁，P<0.05]，男女比例为2.4∶1（西医院为2.7∶1，中医院为1.6∶1，P<0.05）。中医院患者中位住院时间为14小时，西医院为11小时（P>0.05）。中医院患者脑血管病史、高血压、糖尿病、高脂血症的发生率以及住院期间心律失常、心功能不全、心源性休克等并发症的发生率均显著高于西医院。1663例AMI患者总死亡率为8.2%（中医院为15.8%，西医院为6.6%，P<0.01）。13家医院包括急诊PCI和溶栓治疗的再灌注率为31.3%（西医院为33.3%，中医院为21.9%，P<0.05）。AMI指南推荐药物的使用比例如下：阿司匹林93.6%，ACEI和ARB 85.1%，β受体阻滞剂78.7%，低分子肝素85.4%，他汀类药物74.7%。