摘要
目的比较2000年和2006年非ST段抬高急性冠脉综合征患者的诊疗策略变化,比较与指南的差距。方法回顾性调查分析547例患者。结果2006年心肌损伤标记物、胸片、心超、动态心电图、运动平板等检查和冠脉造影率比2000年增高,而负荷核素心肌显像、CT冠状动脉成像检查率降低;2006年比2000年阿司匹林、阿司匹林负荷量、β-受体阻滞剂、ACEI、噻吩并吡啶类化合物、GPⅡb/Ⅲa受体拮抗剂、他汀类使用率和有创干预率均高,而吗啡、硝酸酯类和普通肝素使用率降低。结论非ST段抬高急性冠脉综合征患者诊疗策略进步明显,尤其是有创检查及治疗;但临床实践与循证指南仍存在差距,特别是β-受体阻滞剂使用及加量、GPⅡb/Ⅲa抑制剂和低分子肝素使用,需进一步提高循证指南的宣传教育。
Objective To compare the diagnosis and management of patients with Non-ST elevation acute coronary syndrome between 2000 and 2006, scale the gap between practice and guidelines. Methods Clinical data of 547 inpatients were retrospectively analyzed. Results Elevated cardiac markers, chest X-Ray, echocardiography, dynamic electrocardiogram,exercise ECG, coronary angiography were used more in 2006 than those in 2000, but the usage of cardiac stress imaging and electron-beam computed tomography was lower. Significant increases in the use of aspirin（ P 〈 0.01 ）, using 300mg first dosage of aspirin（ P 〈 0.01 ）, β-blocker（ P 〈 0.01 ）, ACEI（ P 〈 0.01 ）, thienopyridine（ P 〈 0.01 ）, GP Ⅱ b/Ⅲ a inhibitor（ P 〈 0.01 ）, statins（ P 〈 0.01 ） and invasive strate- gies（ P 〈 0.01 ） were found between 2006 and 2000. The utilization rate of morphine sulfate, nitrates, unfractionated heparin were lower. Conlusions There were great progress in the diagnosis and management of patients with Non-ST elevation acute coronary syn- drome between, n 2000 and 2006. Still, further improvements are needed for optimal implementation of these guidelines such as the use of β-blocker, adding dosage of β-blocker, GP Ⅱ b/Ⅲ a inhibitor, low-molecular-weight heparin.
出处
《心脑血管病防治》
2008年第2期88-90,共3页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
