CAJ | 학술논문

目的了解2006至2012年急性冠状动脉综合征(ACS)住院患者诊疗情况的变化.方法分别于2006年在全国31个省、自治区和直辖市65家医院(中国冠心病二级预防架桥工程Ⅰ期研究)和2012年在全国21个省、自治区和直辖市34家医院(中国冠心病二级预防架桥工程Ⅲ期研究)连续入选≥18岁的住院冠心病患者3 323例和3 391例.排除因外伤入院并怀疑ACS者及已参加任何一项药物临床试验者.将其中调查资料完整的ACS患者纳入本研究,2次调查的有效病例数均为3 124例.结果 (1)2012年入选患者的年龄小于2006年入选患者的年龄[(61.9±11.2)岁比(64.7±11.5)岁,P＜0.01],中青年(≤60岁)患者的比例较2006年入选的患者高[42.5％(1 327/3 124)比32.1％(1 004/3 124),P＜0.01].(2)2012年入选患者合并高血压[59.3％(1 853/3 124)比53.0％(1 655/3 124)]、糖尿病[24.3％ (760/3 124)比16.4％ (513/3 124)]、高胆固醇血症[20.3％(633/3 124)比6.3％(197/3 124)]的比例较2006年入选患者高(P均＜0.01).(3)冠状动脉造影检查率由2006年的28.6％(894/3 124)增加至2012年的68.6％ (2 144/3 124)(P＜0.01).经皮冠状动脉介入治疗率由2006年的24.6％(770/3 124)增加至2012年的51.0％(1 594/3 124)(P＜0.01).(4) 2012年入选患者住院期间阿司匹林[95.2％ (2 975/3 124)比91.7％ (2 864/3 124)]、氯吡格雷[85.6％(2 673/3 124)比42.2％(1 318/3 124)]和他汀类药物[90.0％ (2 812/3 124)比69.8％(2 180/3 124)]的使用率均高于2006年入选患者(P均＜0.01).结论与2006年比较,2012年我国ACS住院患者发病年龄年轻化,合并多重危险因素的比例增加,临床诊治水平提高.
목적 료해2006지2012년급성관상동맥종합정(ACS)주원환자진료정황적변화.방법 분별우2006년재전국31개성、자치구화직할시65가의원(중국관심병이급예방가교공정Ⅰ기연구)화2012년재전국21개성、자치구화직할시34가의원(중국관심병이급예방가교공정Ⅲ기연구)련속입선≥18세적주원관심병환자3 323례화3 391례.배제인외상입원병부의ACS자급이삼가임하일항약물림상시험자.장기중조사자료완정적ACS환자납입본연구,2차조사적유효병례수균위3 124례.결과 (1)2012년입선환자적년령소우2006년입선환자적년령[(61.9±11.2)세비(64.7±11.5)세,P＜0.01],중청년(≤60세)환자적비례교2006년입선적환자고[42.5％(1 327/3 124)비32.1％(1 004/3 124),P＜0.01].(2)2012년입선환자합병고혈압[59.3％(1 853/3 124)비53.0％(1 655/3 124)]、당뇨병[24.3％ (760/3 124)비16.4％ (513/3 124)]、고담고순혈증[20.3％(633/3 124)비6.3％(197/3 124)]적비례교2006년입선환자고(P균＜0.01).(3)관상동맥조영검사솔유2006년적28.6％(894/3 124)증가지2012년적68.6％ (2 144/3 124)(P＜0.01).경피관상동맥개입치료솔유2006년적24.6％(770/3 124)증가지2012년적51.0％(1 594/3 124)(P＜0.01).(4) 2012년입선환자주원기간아사필림[95.2％ (2 975/3 124)비91.7％ (2 864/3 124)]、록필격뢰[85.6％(2 673/3 124)비42.2％(1 318/3 124)]화타정류약물[90.0％ (2 812/3 124)비69.8％(2 180/3 124)]적사용솔균고우2006년입선환자(P균＜0.01).결론 여2006년비교,2012년아국ACS주원환자발병년령년경화,합병다중위험인소적비례증가,림상진치수평제고.
Objective To observe the changes in the diagnosis and treatment of hospitalized patients with acute coronary syndrome (ACS) from 2006 to 2012 in China.Methods Hospitalized patients with ACS in 2006 from 65 hospitals distributed in 31 provinces,autonomous regions,and municipalities (data derived from the BRIG project phase Ⅰ study,n =3 323) and hospitalized in 2012 from 34 hospitals distributed in 21 provinces,autonomous regions,and municipalities (data derived from the BRIG project phase Ⅲ study,n =3 391) were included.Patients with susceptible ACS,patients admitted to hospital due to trauma,or patients participated in any drug clinical trials were excluded.Only patients with complete data were analyzed.Data between 3 124 ACS patients from BRIG project-Ⅰ and 3 124 ACS patients from BRIG project-Ⅲ were compared.Results (1) The ACS patients hospitalized in 2012 were younger than those hospitalized in 2006 ((61.9 ± 11.2) years vs.(64.7 ± 11.5) years,P ＜ 0.01),and the percentage of patients ≤60 years was higher in patients hospitalized in 2012 ((42.5％ (1 327/3 124)) compared with those hospitalized in 2006 (32.1％ (1 004/3 124),P ＜ 0.05).(2) The percentages of ACS patients complicated with hypertension ((61.2％ (1 853/3 124) vs.53.0％ (1 655/3 124)),diabetes (24.3％ (760/3 124) vs.16.4％ (513/3 124)),and hypercholesterolemia (20.3％ (633/3 124) vs.6.3％ (197/3 124)) were consistently higher in ACS patients hospitalized in 2012 than in hospitalized ACS patients in 2006 (all P ＜ 0.01).(3) The rate of coronary angiogram examination increased from 28.6％(894/3 124) in 2006 to 68.6％ (2 144/3 124) in 2012 (P ＜ 0.01).Moreover,the rate of intervention treatment was increased from 24.6％ (770/3 124) in 2006 to 51.0％ (1 594/3 124) in 2012(P ＜0.01).(4) The administration rate of aspirin (95.2％ (2 975/3 124)vs.91.7％ (2 864/3 124)),clopidogrel (85.6％ (2 673/3 124) vs.42.2％ (1 318/3 124)),and statins (90.0％ (2 812/3 124) vs.69.8％ (2 180/3 124)) was significantly higher in 2012 than in 2006 (all P ＜ 0.01).Conclusion Compared with 2006,there is a trend of younger onset age for ACS and higher proportions of complicated cardiovascular diseases,as well as improved diagnosis and treatment strategies for Chinese ACS patients in 2012.