Chinese Academy of Medical Sciences, Beijing, China.
Chin Med J (Engl). 2012 Dec;125(24):4361-7.
Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy.
Between June 2007 and October 2009, 16 860 patients aged 50 - 80 years with established history of atherosclerotic vascular disease (coronary heart disease (CHD), atherosclerotic cerebrovascular disease (CVD), or peripheral arterial disease (PAD)) from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics.
Among the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients (61% vs. 10% vs. 22% respectively) and decreased significantly with time from initial diagnosis. Simvastatin (mainly 20 mg) and atorvastatin (mainly 10 mg) each accounted for about 40% of total statin use.
In urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.
尽管在过去几十年中，各种人群中心血管疾病患者的治疗水平有了显著提高，但中国各种动脉粥样硬化血管疾病患者（冠心病、缺血性脑卒中、外周动脉疾病）的长期治疗模式数据仍有限，尤其是他汀类药物治疗的应用。
2007 年 6 月至 2009 年 10 月，在中国 14 个城市的 51 家医院筛选出了 16860 例年龄在 50-80 岁之间、有明确动脉粥样硬化血管病史（冠心病、缺血性脑卒中、外周动脉疾病）的患者，进行一项大型随机试验。根据既往病史记录并分析了当前他汀类药物和其他各种治疗方法的使用情况，并对各种基线特征进行了调整。
在 16860 例患者中，平均年龄为 63 岁，74%为男性。总体而言，78%的患者有冠心病确诊史，40%有缺血性脑卒中病史，5%有外周动脉疾病，21%的患者报告有超过一种疾病。从首次血管疾病诊断到筛选的中位时间为 18 个月。在筛选时，接受各种治疗的患者比例为：抗血小板药物 83%、β受体阻滞剂 49%、他汀类药物 47%和血管紧张素转换酶抑制剂 28%。冠心病患者接受他汀类药物治疗的比例明显高于缺血性脑卒中或外周动脉疾病患者（分别为 61%、10%和 22%），且随着首次诊断时间的延长而显著下降。辛伐他汀（主要为 20mg）和阿托伐他汀（主要为 10mg）分别占他汀类药物总用量的 40%左右。
在中国城市地区，各种已证实的二级预防治疗方法仍未得到充分应用，缺血性脑卒中患者尤其较少使用他汀类药物。
