论文部分内容阅读
目的 :了解我国各医院对急性心肌梗死 (AMI)临床诊治以及出院后长期 2级预防治疗的基本模式。方法 :在全国选择较有代表性的 2 5 0 0余家医院 ,采用统一问卷的方式对各院心血管病主管医生进行调查。结果 :本次调查共收回有效问卷 1919份 ,应答率为 77%。调查显示 ,具有降低死亡等积极疗效的抗血小板、静脉溶栓和血管紧张素转换酶抑制剂 (ACEI)等药物已成为我国AMI治疗的常规手段。 90 %左右的被调查医生对这些药物的疗效均有明确认识。 82 %的医生认为 β 受体阻滞剂对AMI有积极疗效 ,但有 5 0 %左右医生以选择性使用为主 ,且用药剂量很小 (约为国外常用剂量的 1/4) ,开始使用的时间也相对较迟。一些对改善患者预后并无积极疗效的药物 (如硫酸镁、钙通道阻滞剂 )或疗效尚不明确的药物 (如中药制剂 ,蛇毒等 )常规使用的情况仍较为普遍 ,尤其是硫酸镁 (47% )和中药制剂 (45 % )。在AMI后的 2级预防中 ,除阿司匹林外 ,对其余几类有效的治疗药物常规使用比例均较低 ,包括ACEI(5 0 % ) ,β 受体阻滞剂 (35 % )和他汀类降胆固醇药物 (2 5 % )。 结论 :目前我国AMI和梗死后 2级预防药物治疗模式与欧美等国家基本相似 ,但仍有不够规范之处。尤其是一些已被证明并无积极疗效的药物使用过度 ,而一些疗效确切的药物
Objective: To understand the basic patterns of clinical diagnosis and treatment of acute myocardial infarction (AMI) and long-term prevention and treatment of grade 2 after discharge from hospitals in our country. Methods: More than 2500 representative hospitals in China were selected to conduct a survey on cardiovascular disease doctors in each hospital by means of a unified questionnaire. Results: A total of 1919 valid questionnaires were collected and the response rate was 77%. Surveys show that anti-platelet, intravenous thrombolysis and angiotensin-converting enzyme inhibitors (ACEIs), which have a positive effect of reducing death, have become routine measures for the treatment of AMI in China. About 90% of the surveyed doctors have a clear understanding of the efficacy of these drugs. 82% of doctors believe that beta-blockers have a positive effect on AMI, but about 50% of doctors use selectively, and the dosage is very small (about one-fourth of the commonly used dose abroad). The time is also relatively late. Some drugs (such as magnesium sulfate, calcium channel blockers) that have no positive effect on improving the prognosis of patients, or the drugs with unclear therapeutic effects (such as traditional Chinese medicine preparations, snake venom, etc.) are still commonly used, especially magnesium sulfate 47%) and traditional Chinese medicine (45%). Among the Grade 2 prophylaxis after AMI, except for aspirin, routine use was lower for the remaining classes of effective therapies, including ACEI (50%), beta-blocker (35%), and statin Cholesterol medication (25%). Conclusion: At present, the treatment models of AMI and grade 2 prophylaxis in our country are basically similar to those in Europe, the United States and other countries, but there are still not enough norms. In particular, some drugs that have been shown to have no active effect are overexploited and some of the most effective drugs