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目的分析基层医院诊断为ST抬高性急性心肌梗死(AM I)的治疗情况。方法查阅132例资料完整的AM I住院病历了解其治疗现状。结果132例患者中阿司匹林应用率达100%,氯吡格雷为18.94%;再灌注治疗包括溶栓及急诊经皮冠状动脉介入治疗(PCI)、择期PCI为34.09%,其中15.15%接受溶栓治疗,急诊PCI为零,18.94%接受择期PCI治疗。硝酸酯类应用率为96.97%;61.36%接受血管紧张素转换酶抑制剂(ACEI)及拮抗剂(ARB)应用;68.94%接受ßβ-受体阻滞剂治疗;89.39%接受中药静脉治疗。住院期间发生的不良心血管事件如心源性休克为2.27%、心力衰竭为11.36%、心脏骤停为3.79%、死亡率为6.06%。结论基层医院AM I的治疗情况与2004年美国心血管病/美国心脏学会(ACC/AHA)指南的要求存在一定差别。
Objective To analyze the treatment of ST-elevated acute myocardial infarction (AMI) in primary hospitals. Methods 132 cases of intact AM I inpatient records were reviewed to understand their treatment status. Results 132 cases of aspirin application rate of 100%, clopidogrel was 18.94%; reperfusion therapy including thrombolysis and emergency percutaneous coronary intervention (PCI), elective PCI was 34.09%, of which 15.15% received thrombolytic therapy , Emergency PCI was zero, 18.94% received elective PCI. The application rates of nitrates were 96.97%, 61.36% were treated with ACE inhibitors and ARBs, 68.94% were treated with β-blockers, 89.39% . Adverse cardiovascular events during hospitalization such as cardiogenic shock were 2.27%, heart failure was 11.36%, cardiac arrest was 3.79%, and mortality was 6.06%. Conclusions The treatment of AM I in primary hospitals is somewhat different from that of the 2004 American College of Cardiology / American Heart Association (ACC / AHA) guidelines.