干旱区生态环境知识资源中心(Arid): 非ST段抬高的急性冠状动脉综合征二年随访

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	非ST段抬高的急性冠状动脉综合征二年随访
其他题名	Two year follow-up of acute ischemic syndrome without ST elevation
	谭慧琼 1; 朱俊 2; 梁岩 2; 章晏 2; 刘力生 2
来源期刊	中华医学杂志
ISSN	0376-2491
出版年	2005
卷号	85 期号:3 页码:184-188
中文摘要	目的研究分析中国地区非ST段抬高的急性冠状动脉综合征患者2年的临床特点、治疗现状及自然病程.方法作为是国际性多中心关于急性冠状动脉综合征登记试验(OASIS)的一部分,中国地区由38家中心共注册因非ST段抬高的急性冠状动脉综合征(包括不稳定心绞痛及非Q波心肌梗死)入院患者2294例,对入选患者的治疗不作任何干预,治疗处理由当地医师决定,按统一方案以填表方式记录其住院的临床特征、治疗措施以及重大事件等,并进行前瞻性的追踪记录2年.患者平均年龄63岁8岁,男性占62.3%.结果 89.8%的患者就诊时存在心电图异常,绝大部分患者为不稳定心绞痛(88.5%).既往有冠心病史者56.2%,其中将近半数曾有心肌梗死,既往病史中高血压、糖尿病、吸烟和卒中分别为57.4%、18.3%、47.6%、7.1%.住院期间药物治疗以抗血小板药物及硝酸酯制剂的应用分别为94.5%、96.6%,beta阻滞剂、钙拮抗剂、转换酶抑制剂的应用分别为67.5%、57.4%和59.1%.出院后药物治疗率逐渐下降,下降幅度20.2%～50.2%,随访2年时抗血小板制剂、硝酸酯制剂、beta阻滞剂、钙拮抗剂、转换酶抑制剂治疗率分别为73.8%、69.4%、43.9%、35.8%、31.6%.2年间分别有43.1%、23.1%和8.2%的患者采取冠状动脉造影(CAA)、经皮冠状动脉介入治疗(PCI)、冠状动脉旁路移植术(CABG)的介入检查及干预治疗.2年的总死亡率8.0%,最常见的死亡原因是严重室性心律失常或猝死,占4.3%.心力衰竭、再发心肌梗死、卒中、大出血的主要事件发生率分别为15.4%、7.9%、4.8%、0.3%.结论中国地区就诊的非ST段抬高的急性冠状动脉患者以不稳定心绞痛居多.住院期间硝酸酯制剂、抗血小板药物,beta阻滞剂、钙拮抗剂及转换酶抑制剂的应用均在半数以上.出院后服药率呈逐渐下降态势.目前中国此类患者的治疗现状为2年死亡率8.0%,最常见死因是严重室性心律失常或猝死.
英文摘要	Objective To analyze the characteristics, treatment, and natural course during two years of the patients with acute coronary ischemic syndrome (ACS) without ST elevation in China as a part of the international multicentre registry of acute ischemic syndrome, Organization to Assess Strategies for Ischemic Syndromes (OASIS). Methods 2294 patients with ACS without ST elevation, including unstable angina pectoris and non-Q-wave rayocardial infarction, aged 63 8, 62.3% being males, were registered and observed for 2 years based on informed consent in the northwest, north, and northeast China. The specific clinical protocols for patients were decided by the attending physicians without outside intervention. The patients’ clinical characteristics, treatments, major events in hospital, and natural course of disease during the period of two years were recorded by filling in Case Report Forms offered by Canadian Cardiovascular Collaboration. Results 89. 8% of the patients showed abnormal ECG. The most probable clinical diagnosis on admission was unstable angina in 88. 5% of the patients and non-Q-wave myocardial infarction in the other 11. 5%. 56. 2% of the patients had past history of coronary artery disease, and nearly half of them had myocardial infarction. 57. 4% , 18. 3% , 47. 6% , and 7. 1% of them had the prior history of hypertension, diabetes, cigarette smoking and stroke respectively. During hospitalization, anti-platelet therapy and nitrate were used in 94. 5% and 96. 6% of the cases respectively, and 67.5% , 57.4% , and 59.l%t of them took (3-blockers, calcium antagonists and angiotensin-converting enzyme inhibitor (ACEI)respectively simultaneously. The medication rate dropped by 20.2% ~50.2% after discharge from hospital. During the two-year follow up the therapeutic rates of anti-platelets, nitrates, (3-blockers, calcium antagonists, and ACEI were 73. 8% , 69.4%, 43.9%, 35.8%, and 31. 6% respectively. During the 2 years 43.1%, 23. 1% , and 8. 2% of the patients underwent coronary angiography, percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABG) respectively. he two-year total mortality was 8. 0%. he most common causes of death were severe an’hythmias or sudden death with an incidence of 4.3%. The major events were refractory angina, heart failure, new MI, stroke, and major bleeding with incidence rates of 29.4%, 15.4%, 7.9%, 4.8% and 0.3%, respectively. Conclusion Most patients with acute ischeinic syndrome without ST elevation in China are diagnosed as unstable angina. The patients with acute ischemic syndrome are diagnosed as unstable angina mostly in China. More than half of the patients are treated with anti-platelets, nitrates, B-bloekers, calcium antagonists, and ACEI during hospitalization. The medication rate gradually decreases after discharge. The two-year mortality is 8.0.% The most common causes of death include severe arrhythmias and sudden death.
中文关键词	心绞痛,不稳定型 ; 心肌梗塞 ; 登记 ; 预后
英文关键词	Angina, unstable Myocardial infarction Registries Prognosis
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL
WOS研究方向	General & Internal Medicine
CSCD记录号	CSCD:1996127
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/207089
作者单位	1.中国医学科学院阜外心血管医院心内科, 北京 100037, 中国; 2.阜外心血管医院心内科中国医学科学院, 北京 100037, 中国
推荐引用方式 GB/T 7714	谭慧琼,朱俊,梁岩,等. 非ST段抬高的急性冠状动脉综合征二年随访[J],2005,85(3):184-188.
APA	谭慧琼,朱俊,梁岩,章晏,&刘力生.(2005).非ST段抬高的急性冠状动脉综合征二年随访.中华医学杂志,85(3),184-188.
MLA	谭慧琼,et al."非ST段抬高的急性冠状动脉综合征二年随访".中华医学杂志 85.3(2005):184-188.