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长城会 2014:中国原创研究:中国心肌梗死注册研究——不同级别医院诊疗质量有差别

2014-10-24 长城心脏病学会议 医学论坛网

中国急性心肌梗死注册(CAMI)研究截至到今年6月底,已入选患者超过2.3万例。阜外心血管病医院杨跃进教授报告了2013年1月1日至2014年3月31日全国108家医院的数据,在发病7天内就诊的急性心肌梗死患者有16023例,平均年龄为61.8岁。 结果显示,73.5%为STEMI患者。42.6%的STEMI患者行急诊PCI治疗,10.3%行溶栓治疗。8.8%非STEMI行急诊PCI治疗

中国急性心肌梗死注册(CAMI)研究截至到今年6月底,已入选患者超过2.3万例。阜外心血管病医院杨跃进教授报告了2013年1月1日至2014年3月31日全国108家医院的数据,在发病7天内就诊的急性心肌梗死患者有16023例,平均年龄为61.8岁。

结果显示,73.5%为STEMI患者。42.6%的STEMI患者行急诊PCI治疗,10.3%行溶栓治疗。8.8%非STEMI行急诊PCI治疗。

在行急诊再灌注治疗的STEMI中,入院至行急诊PCI时间(D2B)为165分钟,入院至溶栓时间(D2N)为130分钟。满足指南D2B<90分钟和D2N<30分钟的患者比例仅为24.3%和19.6%。

研究还发现,三个级别医院的患者存在明显差别:到省级医院就诊的患者中有36.1%为转诊,而县医院仅为4.2%。到省级医院就诊的患者仅有17%患者能在发病3小时内到达医院,县医院的则有30%。在校正相关危险因素后,省级医院住院死亡率为3.5%,市级医院为5.6%,县级医院为10.0%。

研究还显示,我国急性心肌梗死普遍就诊较晚,其中22.4%STEMI和38.9%非STEMI患者发病后超过24小时到医院。在我国急性心肌梗死患者中九成患者至少伴有高血压、吸烟、糖尿病、超重或肥胖以及高血脂等心血管病危险因素中的1种,35%的患者伴有≥3种的危险因素。


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