急性ST段抬高型心肌梗死患者口服药物变化的分析

目的 探讨近15年循证医学的发展对阿司匹林、β受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拈抗剂(ARB)在急性ST段抬高型心肌梗死(STEMI)患者住院期间使用比率的影响.方法 从1994年1月到2009年12月宣武医院心脏科住院的STEMI患者中选取初发且发病时限在24 h内的患者879例,按时间分为4组:1994年1月～1995年12月(A组)、1999年1月～2000年12月(B组)、2004年1月～2005年12月(C组)、2009年1月～12月(D组),分别对其临床诊治资料做回顾性分析.结果 近15年STEMI患者住院期间的阿司匹林使用率一直维持在97%以上,是4种药物中使用率最高的.β受体阻滞剂、他汀类药物、ACEI/ARB的使用率有了明显的上升,分别从1994年的37.9%、7.2%、25.3%上升为2009年的90.2%、95.5%、93.2%.结论 近15年,在循证医学的规范和指导下,阿司匹林、β受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)在STEMI中使用地位日益巩固.

Abstract：

Objective To investigate the results of evidence-based medicine on use of aspirin, beta blockers, statin, angiotensin-converting enzyme inhibitors (ACEIs) /angiotensin receptor blockers (ARBs) in hospitalized patients with ST-segment elevation (STEMI) during 15 years. Methods Selected four groups of patients with acute myocardial infarction admitted to cardiology department of Xuanwu hospital between January 1994 and December 2009:1994. 1-1995.12 (group A), 1999. 1-2000. 12 (group B), 2004. 1 2005. 12-(group C), 2009. 12( group D). A total of 879 patients with STEMI whose emergency time within 24 hours were retrospectively analyzed. Results The utilization rate of aspirin in STEMI patients remained more than 97%, the highest utilization among four kinds of medicine. The in-hospital utilization rates of Beta blockers, statins, ACEI/ARB rose significantly: from 7.2%, 25.3%, 37.9% to 93.2%, 90.2%, 95.5% respectively during 15 years. Conclusion With the development of evidence-based medicine, the used status of aspirin, beta blockers, statins, ACEI/ARB in STEMI patients haveconsolidated in recently 15 years.

Analysis of oral medication in patients with acute myocardial infarction

Objective To investigate the results of evidence-based medicine on use of aspirin, beta blockers, statin, angiotensin-converting enzyme inhibitors (ACEIs) /angiotensin receptor blockers (ARBs) in hospitalized patients with ST-segment elevation (STEMI) during 15 years. Methods Selected four groups of patients with acute myocardial infarction admitted to cardiology department of Xuanwu hospital between January 1994 and December 2009:1994. 1-1995.12 (group A), 1999. 1-2000. 12 (group B), 2004. 1 2005. 12-(group C), 2009. 12( group D). A total of 879 patients with STEMI whose emergency time within 24 hours were retrospectively analyzed. Results The utilization rate of aspirin in STEMI patients remained more than 97%, the highest utilization among four kinds of medicine. The in-hospital utilization rates of Beta blockers, statins, ACEI/ARB rose significantly: from 7.2%, 25.3%, 37.9% to 93.2%, 90.2%, 95.5% respectively during 15 years. Conclusion With the development of evidence-based medicine, the used status of aspirin, beta blockers, statins, ACEI/ARB in STEMI patients haveconsolidated in recently 15 years.