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2001至2011年中国西部农村地区医院急性心肌梗死患者早期阿司匹林使用趋势
作者:
作者单位:

(中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 国家心血管疾病临床医学研究中心心血管疾病国家重点实验室 中国牛津国际医学研究中心,北京市 100037)

作者简介:

刘佳敏,硕士,副主任医师,研究方向为心血管领域临床研究,E-mail为jiamin.liu@fwoxford.org。

基金项目:

国家卫生和计划生育委员会卫生公益性行业科研专项(201502009)；国家科技部科技支撑计划(2013BAI09B01、2015BAI12B01、2015BAI12B02)


Trend of aspirin use in patients with acute myocardial infarction in rural hospitals of Western China from 2001 to 2011
Author:
  • LIU Jia-Min

    LIU Jia-Min

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • BAI Xue-Ke

    BAI Xue-Ke

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • GAO Yan

    GAO Yan

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • HU Shuang

    HU Shuang

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • FENG Fang

    FENG Fang

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • WANG Xiu-Ling

    WANG Xiu-Ling

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • HUO Xi-Qian

    HUO Xi-Qian

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • SUN Ying

    SUN Ying

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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  • JIANG Li-Xin

    JIANG Li-Xin

    National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037
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Affiliation:

National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, China Oxford Centre for International Health Research, Beijing 100037)

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    摘要:

    目的 评价2001至2011年中国西部农村地区医院急性心肌梗死(AMI)患者住院早期阿司匹林的使用率、变化趋势及影响因素。 方法 采用两阶段随机抽样设计获取2001、2006、2011年西部农村地区医院AMI患者具有代表性的样本。分析3个研究年份患者水平住院早期阿司匹林加权使用率及变化趋势,以代表西部农村地区医院AMI住院患者的整体情况。分析医院水平阿司匹林使用率时排除入选人数＜5的医院,以期反应医院的整体水平。采用Logistic回归方法分析影响阿司匹林使用的相关因素。 结果 共32家西部农村地区医院的1006例AMI患者纳入研究,患者中位年龄为66岁,女性占26.9%。2001至2011年,阿司匹林早期加权使用率有明显改善(2001年69.9%、2006年84.9%和2011年88.8%,趋势P值＜0.0001),而且从医院水平看,早期阿司匹林服药率亦呈逐年上升趋势。然而,即使在2011年,仍有2家医院(约占10%)早期阿司匹林使用率低于80%(分别为55.6%和69.2%)。多因素Logistic分析显示,入院时合并胸部不适(OR 4.6,95%CI 2.7～7.8)和有PCI能力医院(OR 3.2,95%CI 1.5～6.7)的患者更倾向于使用阿司匹林,而非ST段抬高型心肌梗死的患者较少使用阿司匹林(OR 0.5,95%CI 0.3～0.8)。 结论 从2001年至2011年,我国西部农村地区医院AMI住院患者中早期阿司匹林使用率呈明显上升趋势,但一些医院和某些特征人群仍有较大的改善空间。

    Abstract:

    Aim To evaluate trend of early aspirin therapy in patients with acute myocardial infarction (AMI) in western rural hospitals in China from 2001 to 2011, and to identify independent factors associated with the use of early aspirin. Methods Two stage random sampling design was used to obtain representative samples of AMI patients in western rural hospitals from 1,6 and 2011. The weighted use rate and trend of aspirin in patient-level at the early stage of hospitalization in 3 years were analyzed to represent the overall situation of AMI inpatients in western rural areas. When the use rate of aspirin in hospital-level was analyzed, the hospitals with less than 5 enrolled cases were excluded, so as to reflect the overall level of western rural hospital. Logistic regression analysis was used to analyze the related factors affecting aspirin use. Results A total of 1006 AMI patients from 32 western rural hospitals were enrolled in this study. The median age of the patients was 66 years old, and the proportion of women was 26.9%. From 2001 to 2011, early weighted use rate of aspirin was significantly improved (69.9% in 1,4.9% in 2006 and 88.8% in 2011, and trend P value＜0.0001). From the hospital-level, the rate of early aspirin medication also showed an increasing trend year by year.However, even in 2011, there were still 2 hospitals (about 10%) with early aspirin use rate of less than 80% (55.6% and 69.2% respectively). Multivariate Logistic analysis showed that patients with chest discomfort at admission (OR 4.6,5%CI 2.7-7.8) and PCI capacity hospitals (OR 3.2,5%CI 1.5-6.7) were more inclined to use aspirin, and non-ST-segment elevation myocardial infarction patients were less likely to use aspirin (OR 0.5,5%CI 0.3-0.8). Conclusion From 2001 to 2011, the use rate of early aspirin in AMI hospitalized patients in rural areas of western China shows an obvious upward trend, but some hospitals and some characteristic populations still have a lot of room for improvement.

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刘佳敏,白雪珂,高岩,胡爽,冯芳,王秀玲,霍西茜,孙颖,蒋立新.2001至2011年中国西部农村地区医院急性心肌梗死患者早期阿司匹林使用趋势[J].中国动脉硬化杂志,2018,26(1):85~90.

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  • 收稿日期:2017-01-17
  • 最后修改日期:2017-07-19
  • 在线发布日期: 2018-02-01

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