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目的比较喀什地区和上海地区急性心肌梗死患者的流行病学特征与治疗方案差异,为提高急性心肌梗死的防治水平提供参考依据。方法收集2012年8月~2013年1月喀什地区第二人民医院心内科收治的急性心肌梗死患者94例和上海第九人民医院心内科收治的急性心肌梗死患者59例,随访时间6个月,对比两地急性心肌梗死患者的发病年龄、性别、冠心病危险因素、文化水平、收入、到院时间、Killip心功能分级、治疗方案及预后、随访心超情况。结果喀什地区急性心肌梗死患者的发病年龄小于上海,男性患者比例高于上海(P<0.01)。经济状况和文化水平低于上海患者,发病至就诊时间长于上海患者(P<0.01)。喀什患者β受体阻滞剂的应用率低于上海(P<0.05),再灌注治疗及经皮冠状动脉介入治疗(PCI)率均明显低于上海患者(P<0.01)。半年后随访,喀什地区心肌梗死继发心力衰竭者明显多于上海(P<0.05)。结论喀沪两地急性心肌梗死患者在性别、年龄、危险因素分布上存在差异,喀什地区β受体阻滞剂的应用率及再灌注率、PCI率较低,并发心力衰竭患者多,需有针对性地加以改进,以提高当地心肌梗死患者的预后。
Objective To compare the epidemiological characteristics and treatment of acute myocardial infarction patients in Kashgar region and Shanghai region and to provide reference for improving the prevention and treatment of acute myocardial infarction. Methods Ninety-four patients with acute myocardial infarction admitted to Cardiology Department of Second People’s Hospital of Kashi Prefecture from January 2012 to January 2013 and 59 patients with acute myocardial infarction admitted to Cardiology Department of Shanghai Ninth People’s Hospital were collected. The patients were followed up for 6 months, Comparing the age of onset, gender, risk factors of coronary heart disease, educational level, income, time to hospital, Killip heart function grading, treatment plan and prognosis, and follow-up of cardiac ultrasonography in patients with acute myocardial infarction. Results The incidence of acute myocardial infarction in Kashgar region was less than that in Shanghai. The proportion of male patients in Shanghai was higher than that in Shanghai (P <0.01). The economic status and educational level were lower in Shanghai patients than in Shanghai patients (P <0.01). The application rate of β-blockers in Kashi patients was lower than that in Shanghai (P <0.05), and the rates of reperfusion and percutaneous coronary intervention (PCI) in Kashi patients were significantly lower than those in Shanghai patients (P <0.01). Six months after follow-up, Kashi patients with myocardial infarction secondary to heart failure were significantly more than in Shanghai (P <0.05). Conclusion There are differences in the distribution of sex, age and risk factors in patients with acute myocardial infarction in both Shanghai and Shanghai. The application rate of β-blockers in Kashi area and the rate of reperfusion and PCI are lower in patients with complicated heart failure. Targeted to be improved to improve the prognosis of patients with local myocardial infarction.