CAJ | 학술논문

目的了解中国多省市急性冠脉综合征(ACS)住院患者糖尿病的患病、知晓及治疗现状.方法以3223例住院诊断的ACS患者为研究对象.2006年在中国31个省市自治区选择32家三级医院和32家二级医院,每家医院以研究启动时点起向前连续选择经住院诊断的ACS患者50份病历.为避免研究可能带来的干预影响,采用回顾形式收集已出院患者的病历,填写统一的表格,分析患者糖尿病的患病、院前知晓及治疗情况.结果 (1)在调查的3223例ACS患者中,男性占67.7%(2183例),女性占32.3%(1040例),平均年龄(65±11)岁;其中心电图ST段抬高心肌梗死占39.8%,非ST段抬高心肌梗死占9.2%,不稳定心绞痛占51.0%;既往有ACS病史者27.1%.(2)3223例ACS住院患者中22.6%有糖尿病,女性(26.3%)高于男性(20.8%,P＜0.01);按地理区域分为7个地区(华北、华东、华南、华中、东北、西北和西南),其中东北地区患者糖尿病患病率最高(28.0%),西南地区最低(17.7%),各地区间的差异具有统计学意义(P＜0.01).(3)在729例糖尿病患者中,入院前知晓率为73.1%,各地区间知晓率的差异具有统计学意义(P＜0.01);入院前糖尿病治疗率为62.1%,在知晓者中治疗率为84.8%;治疗率最高的是西北地区(88.6%),最低是华中地区(78.4%).(4)既往有ACS史的患者中糖尿病的患病率为27.1%,知晓率为82.3%,知晓者的治疗率为86.7%,上述三率均高于既往无ACS病史者(21.0%、68.7%和83.7%).结论 ACS住院患者中近1/4伴有糖尿病;入院前糖尿病知晓率为73.1%;治疗率为62.1%.在知晓有糖尿病的患者中,仍然有15%未接受降糖治疗,这在冠心病二级预防中应当引起重视.
목적 료해중국다성시급성관맥종합정(ACS)주원환자당뇨병적환병、지효급치료현상.방법 이3223례주원진단적ACS환자위연구대상.2006년재중국31개성시자치구선택32가삼급의원화32가이급의원,매가의원이연구계동시점기향전련속선택경주원진단적ACS환자50빈병력.위피면연구가능대래적간예영향,채용회고형식수집이출원환자적병력,전사통일적표격,분석환자당뇨병적환병、원전지효급치료정황.결과 (1)재조사적3223례ACS환자중,남성점67.7%(2183례),녀성점32.3%(1040례),평균년령(65±11)세;기중심전도ST단태고심기경사점39.8%,비ST단태고심기경사점9.2%,불은정심교통점51.0%;기왕유ACS병사자27.1%.(2)3223례ACS주원환자중22.6%유당뇨병,녀성(26.3%)고우남성(20.8%,P＜0.01);안지리구역분위7개지구(화북、화동、화남、화중、동북、서북화서남),기중동북지구환자당뇨병환병솔최고(28.0%),서남지구최저(17.7%),각지구간적차이구유통계학의의(P＜0.01).(3)재729례당뇨병환자중,입원전지효솔위73.1%,각지구간지효솔적차이구유통계학의의(P＜0.01);입원전당뇨병치료솔위62.1%,재지효자중치료솔위84.8%;치료솔최고적시서북지구(88.6%),최저시화중지구(78.4%).(4)기왕유ACS사적환자중당뇨병적환병솔위27.1%,지효솔위82.3%,지효자적치료솔위86.7%,상술삼솔균고우기왕무ACS병사자(21.0%、68.7%화83.7%).결론 ACS주원환자중근1/4반유당뇨병;입원전당뇨병지효솔위73.1%;치료솔위62.1%.재지효유당뇨병적환자중,잉연유15%미접수강당치료,저재관심병이급예방중응당인기중시.
Objective To demonstrate the current prevalence and treatment status of diabetes mellitus (DM) among inpatients with acute coronary syndrome (ACS) in China. Methods Sixty-four hospitals, including 32 secondary hospitals and 32 tertiary hospitals were selected for baseline survey. Fifty inpatients diagnosed with ACS were recruited consecutively from hospitals participated in this study. This paper focused on the prevalence and treatment status of DM among inpatients with ACS. Results (1)Clinical data of 3223 inpatients (average age 65±11 ) with ACS were collected during baseline survey,including 2183(67.7%) males and 1040(32.3%) females. Among them,39.8% were diagnosed as ST-segment elevation myocardial infarction ( MI), 9.2% as non-ST-segment elevation MI, 51.0% as unstable angina,and 27.1% with ACS history. (2) DM was found in 22.6% ACS patients. The prevalence rate of DM was higher in female (26.3%) patients than that in males (20.8%). The rate of DM was the highest(28.0%) in northeast area and lowest (17.7%) in southwest among 7 geographic districts (north, east,south,central,northeast,northwest and southwest parts of the country). Significant difference was observed among these areas. (3) Rate of awareness on DM was 73.1% among patients with DM, with significant differences among various areas. Treatment rate was 62.1% among patients with DM, with the highest(88.6%) seen in northwest and the lowest (78.4%) in central part of China. (4) Rates of prevalence(27.1%), awareness (82.3%) and treatment (86.7%) of DM were higher in recurrent ACS patients than in those without ACS history, Conclusion Nearly one-forth of the ACS inpatients were having DM, and 15% of the patients with known DM were not on anti-diabetic treatment. It is essential to pay more attention on the treatment of DM for the purpose of secondary prevention on cardiovascular disease.