贵州医科大学学报

2015, v.40;No.183(12) 1417-1419+1423

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贵阳市冠心病患者PCI术后二级预防现状及影响因素
Analysis of the Current Situation and Influence Factors of Secondary Prevention after PCI in Patients with Coronary Heart Disease

杨熙;李屏;
YANG Xi;LI Ping;Teaching Division of Internal Medicine,Guizhou Medical University;Department of Internal Medicine-Cardiovascular,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:了解贵阳冠状动脉粥样硬化性心脏病(CHD)经皮冠状动脉介入治疗(PCI)术后二级预防现状及影响因素。方法:选取贵阳地区行PCI术治疗的846例CHD患者,术后随访记录患者用药依从性及危险因素控制情况,观察二级预防依从性的影响因素;将患者分为二级预防良好组和二级预防欠佳组,比较两组患者主要终点事件、次要终点事件,全因死亡率及再住院率。结果:随访时CHD患者阿司匹林、氯吡格雷、他汀类药物的使用情况较好,血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)及β受体阻滞剂使用情况欠佳,随访时用药率明显下降(P<0.01);CHD患者主要高危因素为血脂异常症(100%)、吸烟(61.74%)、高血压(57.14%)及糖尿病(36.62%),随访时对危险因素的控制较住院期间明显改善;影响二级预防依从性的因素主要有性别、年龄、医疗付费方式;二级预防良好组患者均未发生主要终点事件及次要终点事件,全因死亡率及再住院率均明显低于二级预防欠佳组患者(P<0.05)。结论:贵阳地区CHD患者PCI术后二级预防实施不够理想,加强CHD患者PCI术后二级预防的管理,可以促进心脏康复及改善预后。
Objective: To investigate current situation and influence factors of secondary prevention after PCI in patients with coronary heart disease( CHD). Method: A total of 846 CHD patients accepted PCI were selected,and medication compliance and risk factors were followed up. Dividing patients into fine secondary prevention group and poor secondary prevention group. Comparing end events,sub-end events,all-cause mortality and rehospitalization rate. Result: Compliance of the patints to aspirin,clopidogrel and statin drugs was fine,the use conditions of ACEI,ARB and beta-blocker was poor,medication during follow-up visit declined( P < 0. 01); High risk factors were: dyslipidemia( 100%),smoking( 61. 74%),hyper-tension( 57. 14%) and diabetes( 36. 62%). Follow-up visit showed better improvement in risk factor control than during hospitalization. Influence factors were as follows: gender,age and medical payment. There were no end-event and sub-end event happened in secondary prevention fine group members,all-cause mortality and rehospitalization rate were lower than poor secondary prevention group( P < 0. 05). Conclusion: Risk factors related to the secondary prevention of CHD should be controled to pomote recovery and prognosis.

关键词(KeyWords): 冠状动脉硬化;心脏病;经皮冠状动脉介入治疗术;二级预防;预后
coronary arteriosclerosis;heart disease;percutaneous coronary interventional therapy;secondary prevention;prognosis

Abstract:

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作者(Author): 杨熙;李屏;
YANG Xi;LI Ping;Teaching Division of Internal Medicine,Guizhou Medical University;Department of Internal Medicine-Cardiovascular,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2015.12.036

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