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目的:对2001-2011年南阳地区急性ST段抬高型心肌梗死(STEMI)患者的临床特征、治疗模式及院内结局进行分析,旨在评价过去10年间该地区STEMI患者诊疗情况的变化趋势。方法:随机抽取2001、2006、2011年我院急性心肌梗死住院病历,提取详细临床信息,分析其中STEMI患者临床特征、治疗模式和院内结局。结果:本研究共抽取急性心肌梗死病历234份,其中217例STEMI患者。结果显示:2001-2011年,阿司匹林、氯吡格雷及他汀的应用显著增加(阿司匹林:2001年79%,2011年94%,P<0.05;氯吡格雷2001年0%,2011年95%,P<0.05;他汀2001年31%,2011年95%,P<0.05),β受体阻滞剂和ACEI类药物应用率仍比较低,且10年间无明显增加(β阻滞剂2001年51%,2011年55%,P>0.05;ACEI类药物2001年61%,2011年59%,P>0.05);未进行再灌注治疗的患者,并无显著改变(2001年43%,2011年47%;P>0.05);院内病死率10年间变化差异无统计学意义(2001年9%,2011年10%;P>0.05)。结论:过去10年间,南阳地区STEMI患者院内再灌注率无明显增加,病死率无显著降低,二级预防用药显著不足。医疗实践与指南之间的重要差距仍持续存在。
Objective: To analyze the clinical features, treatment modalities and hospital outcomes of patients with STEMI in Nanyang district from 2001 to 2011, and to evaluate the trend of diagnosis and treatment of STEMI patients in this area in the past 10 years. Methods: The hospital records of acute myocardial infarction in our hospital from 2001, 2006 and 2011 were randomly selected and the detailed clinical information was extracted. The clinical features, treatment modalities and hospital outcomes of STEMI patients were analyzed. Results: In this study, 234 cases of acute myocardial infarction were collected, of which 217 cases of STEMI patients. The results showed that the use of aspirin, clopidogrel and statin was significantly increased from 2001 to 2011 (aspirin: 79% in 2001, 94% in 2011, P <0.05; 0% in clopidogrel in 2001; 95% in 2011; P <0.05; statin 31% in 2001, 95% in 2011, P <0.05), the application rate of β-blockers and ACEIs was still relatively low, and there was no significant increase in 10 years (β blockers 51% , 55% in 2011, P> 0.05; 61% in ACEIs in 2001 and 59% in 2011, P> 0.05). There was no significant change in patients without reperfusion therapy (43% in 2001, 47% ; P> 0.05). There was no significant difference in hospital mortality in 10 years (9% in 2001, 10% in 2011; P> 0.05). Conclusion: In the past 10 years, there was no significant increase in in-hospital reperfusion rate in STEMI patients in Nanyang District, with no significant reduction in mortality and a significant shortage of secondary prevention medication. The important gap between medical practice and guidance persists.