2006 年至 2013 年中国中医院急性心肌梗死住院患者 2311 例分析——基于医院数据
Acute Myocardial Infarction in Chinese Medicine Hospitals in China from 2006 to 2013: An Analysis of 2311 Patients from Hospital Data.
机构信息
Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China.
出版信息
Chin J Integr Med. 2021 May;27(5):323-329. doi: 10.1007/s11655-020-3189-1. Epub 2020 Feb 27.
OBJECTIVE
To assess the trends in characteristics, treatments, and outcomes of acute myocardial infarction (AMI) patients in tertiary Chinese medicine (CM) hospitals in China between 2006 and 2013.
METHODS
This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years (2006 and 2013). Patients admitted to the hospital for AMI were enrolled. Hospital records were used as the data source. Case data were derived regarding baseline characteristics, treatments, and outcomes of patients to assess changes from 2006 to 2013. Logistic regression was used to analyze the relationship between prognosis, general influencing factors of disease, and various treatment measures.
RESULTS
Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013 (18 were repetitive) were surveyed. A total of 2,311 patients with AMI were enrolled (1,094 cases in 2006 and 1,217 cases in 2013). From 2006 to 2013, the mean age did not significantly change, but the proportion of patients younger than 65 years increased. The prevalence of risk factors such as hypertension, diabetes, and hyperlipidemia also increased. Significant increases were observed in primary percutaneous coronary intervention [20.48% (2006) vs. 24.90% (2013)] and revascularization [36.11% (2006) vs. 52.42% (2013)]. In-hospital mortality decreased from 11.15% in 2006 to 10.60% in 2013. A mortality logistic regression analysis identified reperfusion therapy [odds ratio (OR), 0.222; 95% confidence interval (CI), 0.106-0.464], Chinese patent medicines (OR, 0.394; 95% CI, 0.213-0.727), and CM decoctions (OR, 0.196; 95% CI, 0.109-0.353) as protective factors.
CONCLUSION
Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly, but in-hospital mortality has not significantly decreased. Efforts are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.
目的
评估 2006 年至 2013 年期间中国三级中医院急性心肌梗死（AMI）患者的特征、治疗方法和结局的变化趋势。
方法
本回顾性研究基于 2 年内（2006 年和 2013 年）对三级中医院 AMI 的两次全国性流行病学调查。纳入因 AMI 住院的患者。医院记录作为数据来源，分析患者的基线特征、治疗方法和结局变化。采用 logistic 回归分析疾病一般影响因素与各种治疗措施与预后的关系。
结果
共调查了 2006 年的 26 家三级中医院和 2013 年的 29 家三级中医院（18 家为重复），共纳入 2311 例 AMI 患者（2006 年 1094 例，2013 年 1217 例）。2006 年至 2013 年，患者平均年龄无显著变化，但 65 岁以下患者比例增加。高血压、糖尿病和高脂血症等危险因素的患病率也有所上升。直接经皮冠状动脉介入治疗[20.48%（2006 年）vs. 24.90%（2013 年）]和血运重建[36.11%（2006 年）vs. 52.42%（2013 年）]显著增加。住院死亡率从 2006 年的 11.15%降至 2013 年的 10.60%。死亡 logistic 回归分析确定了再灌注治疗[比值比（OR），0.222；95%置信区间（CI），0.106-0.464]、中药成药（OR，0.394；95%CI，0.213-0.727）和中药汤剂（OR，0.196；95%CI，0.109-0.353）为保护因素。
结论
三级中医院的再灌注和血运重建能力显著提高，但住院死亡率无显著降低。需要努力提高中国对 AMI 的医学认识并扩大中药的应用，以降低住院死亡率。
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