中国全科医学2017，Vol.20Issue(32)：4042-4046,5.DOI:10.3969/j.issn.1007-9572.2017.00.030
中国东部城市医院急性心肌梗死患者心肌标志物检测情况十年趋势——China PEACE回顾性研究结果
Trends in Cardiac Biomarker Testing in Patients with Acute Myocardial Infarction in Hospitals in Eastern Urban China from 2001 to 2011 : a China PEACE-retrospective AMI Study
摘要
Abstract
Objective To describe the trend of biomarker testing in patients with acute myocardial infarction (AMI)in hospitals in eastern urban China from 2001 to 2011.Methods From October 2011 to June 2013,we conducted the China Patient-Centered Evaluative Assessment of Cardiac Events (China PEACE)-retrospective AMI study.Two-stage random sampling was used to collect the general data of the sampled hospitals and profiles of their AMI patients:in the first stage,we identified sample hospitals using a simple random sampling from the tertiary grade A hospitals in eastern urban China;in the second stage,we drew cases discharged in 2001,2006 and 2011 based on the local hospital database for patients with AMI at eacb sampled hospital using systematic random sampling.Based on analyzing the data of the investigated hospital and the profiles of corresponding AMI patients,we described the temporal trends in the use of cardiac biomarker testing and proportion of AMI patients with cardiac biomarker testing in these hospitals,as well as the proportion of AMI patients with troponin testing in the hospitals with testing capability.Results Totaled 32 hospitals in eastern urban China participated in the study and 5 667 AMI patients were included in analysis of biomarker use.Number of hospitals included in 2001,2006 and 2011 was 27,29 and 32,respectively.Number of patients included in 2001,2006 and 2011 were 1 003,1 579 and 3 085,respectively.The proportion of hospitals performing the testing of any type of biomarkers were 96.3％ (26/27),96.6％ (28/29),100.0％ (32/32) in 2001,2006 and 2011,respectively with no significant difference among them (test statistic =-0.975,P =0.330).The proportion of hospitals with troponin testing capability increased significantly (test statistic =-3.831,P ＜ 0.001) year after year,which was 55.6％ (15/27),79.3％ (23/29),96.9％ (31/32) in 2001,2006 and 2011.The proportion ofAMI patients undergoing biomarker testing in 2001,2006 and 2011 were 83.75％ (840/1 003),90:44％ (1 428/1 579),95.79％ (2 955/3 085),respectively with significant difference (test statistic =-12.661,P ＜0.001).The.proportion of AMI patients undergoing troponin testing increased significantly (test statistic =-24.190,P ＜ 0.001) by year,which were 30.91％ (310/1 003),52.56％ (830/1 579),72.41％ (2 234/3 085) in 2001,2006 and 2011,respectively.There was significant difference in the proportion of troponin testing for AMI patients among all the hospitals with troponin testing capability in 2001 2006 and2011 (x22001 =653.145,P＜0.001;x22006=1 080.538 P＜0.001;x22011 =1 372.946,P＜0.001).In 2011,hospitals of which the proportion of troponin testing in AMI patients was over 80.0％ only accounted for 64.5％ (20/31).Conclusion During 2001 to 2011,biomarker tests for AMI diagnosis become gradually available in hospitals in eastern urban China,and troponin testing is accessible in most hospitals,but some of them need to improve the use of troponin testing in the diagnosis of AMI.And there is still room left to improve the compliance of clinical practice to guidelines in the medical care of AMI in these hospitals.关键词
心肌梗死/肌钙蛋白/肌酸激酶,MB型/心肌标志物Key words
Myocardial infarction/Troponin/Creatine kinase, MB type/Cardiac biomarker分类
医药卫生引用本文复制引用
王斌,郑昕,白雪珂,吴超群,李静,李希,蒋立新..中国东部城市医院急性心肌梗死患者心肌标志物检测情况十年趋势——China PEACE回顾性研究结果[J].中国全科医学,2017,20(32):4042-4046,5.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(201202025,201502009) （201202025,201502009）
国家科技部科技支撑计划(2015BAI12B01,2015BAI12B02) （2015BAI12B01,2015BAI12B02）
高等学校学科创新引智计划资助(B16005) （B16005）
