中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
6期
509-511
,共3页
陈书艳%王燕%曹青%顾晔%杨丹英%施金莹%王烨%马婵娟%蒋雪妹
陳書豔%王燕%曹青%顧曄%楊丹英%施金瑩%王燁%馬嬋娟%蔣雪妹
진서염%왕연%조청%고엽%양단영%시금형%왕엽%마선연%장설매
他汀类药物%冠心病%血脂%危险分层
他汀類藥物%冠心病%血脂%危險分層
타정류약물%관심병%혈지%위험분층
Statin%Coronary heart disease%Serum lipids%Risk stratification
目的 了解干部保健人群中,他汀类药物在冠状动脉粥样硬化性心脏病(冠心病)一、二级预防中的应用情况及其与指南的差距,并分析可能的原因.方法 观察2009年8月至10月定点在我院体检的干部保健对象共767人,通过问卷调查及查阅既往病史、体格检查和实验室检查的结果,将研究对象进行危险分层,了解研究对象应用他汀类药物的情况、治疗效果与指南的差距并分析可能的原因.结果 接受调查的干部保健对象中,符合心血管疾病危险分层的高危和极高危者522例,占68.06%.符合标准并已经接受过或正在接受他汀类药物治疗者185人,占符合药物治疗标准者的41.67%.符合治疗标准而未接受他汀类药物治疗者259人,占符合药物治疗标准者的58.33%.其中医生未处方他汀类药物或处方其他降脂药193人,是患者未接受他汀类药物治疗的主要原因,占未用他汀类药物原因的43.47%.Logistic回归分析显示:医生是否处方他汀类药物主要与年龄、冠状动脉血运重建、周围血管动脉硬化有关(P＜0.05).结论 干部保健对象中他汀类药物临床应用与指南有很大的差距,关键因素在医生,应加强医生对指南的学习,同时应加强对患者的健康教育.
目的 瞭解榦部保健人群中,他汀類藥物在冠狀動脈粥樣硬化性心髒病(冠心病)一、二級預防中的應用情況及其與指南的差距,併分析可能的原因.方法 觀察2009年8月至10月定點在我院體檢的榦部保健對象共767人,通過問捲調查及查閱既往病史、體格檢查和實驗室檢查的結果,將研究對象進行危險分層,瞭解研究對象應用他汀類藥物的情況、治療效果與指南的差距併分析可能的原因.結果 接受調查的榦部保健對象中,符閤心血管疾病危險分層的高危和極高危者522例,佔68.06%.符閤標準併已經接受過或正在接受他汀類藥物治療者185人,佔符閤藥物治療標準者的41.67%.符閤治療標準而未接受他汀類藥物治療者259人,佔符閤藥物治療標準者的58.33%.其中醫生未處方他汀類藥物或處方其他降脂藥193人,是患者未接受他汀類藥物治療的主要原因,佔未用他汀類藥物原因的43.47%.Logistic迴歸分析顯示:醫生是否處方他汀類藥物主要與年齡、冠狀動脈血運重建、週圍血管動脈硬化有關(P＜0.05).結論 榦部保健對象中他汀類藥物臨床應用與指南有很大的差距,關鍵因素在醫生,應加彊醫生對指南的學習,同時應加彊對患者的健康教育.
목적 료해간부보건인군중,타정류약물재관상동맥죽양경화성심장병(관심병)일、이급예방중적응용정황급기여지남적차거,병분석가능적원인.방법 관찰2009년8월지10월정점재아원체검적간부보건대상공767인,통과문권조사급사열기왕병사、체격검사화실험실검사적결과,장연구대상진행위험분층,료해연구대상응용타정류약물적정황、치료효과여지남적차거병분석가능적원인.결과 접수조사적간부보건대상중,부합심혈관질병위험분층적고위화겁고위자522례,점68.06%.부합표준병이경접수과혹정재접수타정류약물치료자185인,점부합약물치료표준자적41.67%.부합치료표준이미접수타정류약물치료자259인,점부합약물치료표준자적58.33%.기중의생미처방타정류약물혹처방기타강지약193인,시환자미접수타정류약물치료적주요원인,점미용타정류약물원인적43.47%.Logistic회귀분석현시:의생시부처방타정류약물주요여년령、관상동맥혈운중건、주위혈관동맥경화유관(P＜0.05).결론 간부보건대상중타정류약물림상응용여지남유흔대적차거,관건인소재의생,응가강의생대지남적학습,동시응가강대환자적건강교육.
Objective To evaluate the statin use among cadres in primary and secondary prevention of coronary heart disease and analyse the potential cause of the difference with the current guidelines.Methods From August to October 2009, 767 cases were randomly enrolled in this research.Clinical data including past medical history, cardiovascular risk factors, and laboratory tests were collected.Risk stratification was determined based on the 2007 Guide to China lipid control.The use of statin and the difference between the guideline was observed.Logistic regression analysis was used to identify the potential cause.Results Totally 68.08% of cases were at high and very high risk of cardiovascular disease.The rate of statin use among such patient population was 41.67%.However, 259 patients with indications for statin were not on drug use, which accounted for 58.33% of the studied subjects.The main cause of statin underuse was due to non-prescription by physicians, which accounted for 43.47% of all causes.Logistic regression analysis suggested that statin prescription was significantly associated with age, coronary revascularization and peripheral artery atheresclerosis (P ＜0.05).Conclusions There is a big gap between current clinical practice and application of guidelines in statin treatment.Clinical doctor as a key factor point should learn more about the guideline and advocate to patients.
