Objective To investigate the current status of interventional therapy and pharmacotherapy for coronary heart disease in county-level hospitals in Yunnan province.Methods A total of 210 cases of coronary heart disease were collected from the county-level hospitals which were randomly selected and were qualified for the interventional treatment of coronary heart disease.All patients were divided into ST-segment elevation myocardial infarction(STEMI) group,non-ST-segment elevation myocardial infarction(NSETMI) group,unstable angina(UA) group and stable angina pectoris(SAP) group.The clinical data and the data of percutanous coronary intervention(PCI) and pharmacotherapy were collected and analyzed in each group.Results A total of 51 STEMI patients,50 NSTEMI patients,75 UA patients and 34 SAP patients were enrolled in the study.In the STEMI group,10 patients(19.6%) received emergency PCI,with the door-to-balloon time of 101.7 ± 20.8 minutes.There were 25 patients(49.0%),36 patients(72.0%),33 patients(84.6%) and 56 patients(74.7%) received selective PCI,respectively,in the STEMI,NSTEMI,UA and SAP groups.A total of 142 patients underwent interventional surgery,with 206 vascular stents(average,1.45 stents/person).During hospitalization,the highest rates of drug use in the STEMI and NSTEMI groups were aspirin and clopidogrel,while in the UA and SAP groups were aspirin and statins.After discharge,the rates of different drug use in different types of patients decreased in different degrees compared to the rates in hospitalization,but the rate of statins or angiotensin converting enzyme inhibitor/angiotensin receptor blocker use in the SAP patients increased in different degrees compared to the rate in hospitalization. Conclusion The interventional therapy and pharmacotherapy for coronary heart disease become more and more standardized in county-level hospitals in Yunnan province,but still have a certain gap compared with the guidance requirement.%目的 了解云南省县级医院冠心病介入治疗与药物治疗的现况.方法 在随机抽取的具有冠心病介入治疗资质的县级医院中,选择210例冠心病患者,分为ST段抬高型心梗(STEMI)组、非ST段抬高型心肌梗死(NSETMI)组、不稳定型心绞痛(UA)组及稳定型心绞痛(SAP)组.收集并分析各组患者的临床资料、经皮冠状动脉介入治疗(PCI)资料、药物治疗资料.结果 本研究共纳入51例STEMI患者,50例NSTEMI患者,75例UA患者,34例SAP患者.STEMI组患者中有10例(19.6%)接受急诊PCI,急诊室至首次球囊扩张时间为(101.7 ± 20.8)min.STEMI、NSTEMI、UA、SAP组中分别有25例(49.0%)、36例(72.0%)、33例(84.6%)、56例(74.7%)患者接受择期PCI.142例接受介入手术的患者共植入支架206枚,人均1.45枚.住院期间,STEMI、NSTEMI组患者药物使用率最高的是阿司匹林和氯吡格雷,UA、SAP组患者药物使用率最高的是阿司匹林和他汀类药物;出院后,不同类型患者的各类治疗药物使用率均较住院时有不同程度下降,但UA组阿司匹林使用率无变化,而SAP患者中他汀类药物和血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂的使用率均较住院时有不同程度升高.结论 云南省基层县级医院在冠心病介入和药物治疗等方面日趋规范,但仍与指南要求存在一定差距.
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