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中国急性心肌梗死注册研究

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中国急性心肌梗死患者心血管危险因素分析 您当前的位置:文章发表 >
摘要
目的:描述中国急性心肌梗死(AMI)患者心血管危险因素的分布情况。
方法:采用中国AMI 注册登记(CAMI)研究的数据,选取从2013-01-01 至2014-03-31 期间全国31 个省、市和
自治区的107 家医院连续入选的AMI 患者(包括ST 段抬高型心肌梗死和非ST 段抬高型心肌梗死),入选患者从发病至医院就诊的时间在7 天之内。危险因素采用调查问卷的方式收集。可纠正危险因素包括吸烟、超重/ 肥胖、高血压、血脂代谢异常、糖尿病;生活方式危险因素包括缺乏运动、喜食肥腻食物;不可纠正危险因素包括早发冠心病家族史。
结果:该研究共收集17 773 例AMI 患者,在数据资料填写完整并纳入分析的15 998 例(90%)患者中,71.1% 为ST段抬高型心肌梗死,74.0% 为男性,平均年龄为(61.8±15.0)岁,平均体重指数为(24.6±12.2)kg/m2。在可纠正的心血管危险因素中,吸烟(54.4%)、超重/ 肥胖(53.9%)和高血压(51.2%)位居前三,其次为糖尿病(19.5%)和血脂代谢异常(7.7%)。26.6% 的AMI 患者有≥ 3 个可纠正的危险因素,而8.7% 的AMI 患者没有任何可纠正的危险因素。3.6% 的患者有早发心血管病家族史。76.2% 的患者经常进食肥腻饮食,79.6% 的患者缺乏运动。与男性患者相比,女性患者年龄较高[(67.4±14.4)岁vs(59.8±14.8)岁],合并高血压(61.8% vs 47.5%)和糖尿病(25.5% vs 17.4%)的患者更多;而男性患者中正在吸烟/ 有吸烟史(69.2% vs 12.1%)和有血脂代谢异常病史的患者(8.1% vs 6.7%)显著多于女性(P均<0.05)≤ 55 岁的患者占27.9%,其中男性(88.9% vs 68.2%)、体重指数[(25.2 ±8.4)kg/m2 vs(24.4 ±13.3)kg/m2]、血脂代谢异常(10.0% vs 6.8%)、吸烟(70.1% vs 48.3%)、有早发心血管家族史(6.6% vs 2.4%)和肥腻饮食(83.4% vs 73.4%)的患者比例均高于年龄>55 岁的患者(P 均<0.05);而>55 岁的患者中合并高血压(55.3% vs 40.7%)和糖尿病(21.1% vs 15.2%)的患者比例高于≤ 55 岁患者(P 均<0.05)。
结论:超过1/4 的中国AMI 患者有≥ 3 个可纠正的心血管危险因素,半数以上AMI 患者有吸烟史、超重/ 肥胖
和高血压;近80% 的AMI 患者有肥腻饮食和缺乏运动等不良生活方式。
关键词 急性心肌梗死;心血管危险因素;吸烟;超重/ 肥胖;高血压
Cardiovascular Risk Factor Analysis for Acute Myocardial Infarction Patients in China
GAO Xiao-jin,YANG Jin-gang, YANG Yue-jin, XU Hai-yan, WU Yuan, LI Wei, WANG Yang, TANG Xin-ran, SUN Yi,
QIAO Guo-fang, SONG Lei, FU Rui, SUN Hui, YAN Xin-xin, DONG Qiu-ting, ZHANG Xuan, YE Yun-qing, JIN Chen, Onbehalf of the study group of China Acute Myocardial Infarction Registry
Department of Cardiology, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037), ChinaCorresponding Author: YANG Yue-jin, Email: yangyjfw@126.com
AbstractObjective: To describe the cardiovascular risk factor distribution for acute myocardial infarction (AMI) patients in China.
Methods: Based onthe information ofChinaacute myocardial infarction (CAMI) registry, we studied 17773
consecutive AMI patients from 107 hospitals among 31 provinces, cities and autonomous districts nationwide form 2013-01-01 to 2014-03-31. The patients included STEMI and non-STEMI, they were admitted within 7 days of onset andthecardiovascular risk factors were collected by questionnaire survey. The reparable risk factors were defined as smoking,over weight/obese, hypertension, dyslipidemia, diabetes, unhealthy living style as lack of excise and taking greasy food;un-reparable risk factor was defined asthe family history of pre mature CAD.
Results:There were 15998/17773 (90%) AMI patients with entire information enrolled for analysis, of whom 71.1%with STEMI and 74.0% with non-STEMI at the mean age of (67.4 ±14.4) years and mean BMI of (24.6±12.2) kg/m2.The first 3 reparable risk factors were smoking (54.4%), weight/obese (53.9%) and hypertension (51.2%), followed bydiabetes (19.5%) and dyslipidemia (7.7%). There were 26.6% AMI patients with≥3 reparable risk factors, 8.7% withoutreparable risk factor; 3.6% with the family history of premature CAD. There were 76.2% of patientstaking moregreasyfood, 79.6% lack of excise. Compared with male patients, female were with elder age (67.4 ±14.4) years vs (59.8 ±14.8)years, more hypertension (61.8% vs 47.5%) and more diabetes (25.5% vs 17.4%); while male patients were more withsmoking history (69.2% vs 21.1%) and dyslipidemia (8.1% vs 6.7%), all P <0.05. There were 4458/15998 (27.9%)patients ≤ 55 years of age, compared with those > 55 years, they were more with male gender (88.9% vs 68.2%), higherBMI (25.2 ±8.4) kg/m2 vs (24.4 ±13.3) kg/m2, more dyslipidemia(10.0% vs 6.8), more smokers (70.1% vs 48.3%), takingmore greasy food (83.4% vs 73.4%), and more family history of premature CAD (6.6% vs 2.4); while the patients > 55
years were more with hypertension (55.3% vs 40.7%) and diabetes (21.1% vs 15.2%), all P <0.05.
Conclusion: There are more than 1/4 AMI patients having ≥3 reparable risk factors, more than half AMI patients
having smoking history, over weight/obese and more than 80% of patients taking more greasy food and lack of excise.Key words Acute myocardial infarction; Cardiovascular risk factors; Smoking;Overweight/obesity;Hypertension
(Chinese Circulation Journal, 2015,30:206.)


http://www.cami-r.com/uploadfile/2015/0402/20150402031647301.pdf