The Short-term Prognosis Of Different Treatment Methods And A Survey Of Current Practice In Patients With Acute Myocardial Infarction Of Ningxia Hui Autonomous Region.

Objective: To explore the short-term prognosis of different treatment methods in patients with acute myocardial infarction of Ningxia hui autonomous region. To analysis clinical current practice among different levels of hospital.Methods:1)Analyzed clinical information about 1990 patients(1367 patients had complete records) with AMI retrospectively by case-control research.1367 patients with AMI were assigned to four groups according to different kinds of therapy: general treatment group(669 patients); intravenous thrombolytic therapy group(151 patients); primary percutaneous coronary intervention group(177 patients);elective percutaneous coronary intervention group(370 patients);compared the information of four group and short-term prognosis(re–angina, malignant ventricular arrhythmia, mortality)2) Analyzed pattern of therapy and situation of drug usage among 1990 patients from tertiary hospitals and second-tier hospital during acute phase of AMI retrospectively.Results:1)The general characteristics of patients showed no significant statistically difference except average age, gender, onset-to-arrival time, door-to-reperfusion time, proportion of patients with STEMI, left ventricular ejection fraction(The first time of accepting UCG after admission ),medical therapy (P<0.05).There was statistically difference in maximal narrowness, number of IRA and collateral circulation between primary PCI group and elective PCI group(P<0.05),the rest of the PCI index were similar across two groups. There was higher incidence of re–angina, malignant ventricular arrhythmia in general treatment group than intravenous thrombolytic therapy group(P<0.05), mortality rate of the two groups showed no significant statistically difference(P>0.05).There was higher mortality rate in thrombolytic therapy group than primary PCI (P<0.05), the rest index of the two groups showed no significant statistically difference(P>0.05). There was higher incidence of malignant ventricular arrhythmia in primary PCI than elective PCI group (P<0.05), the rest index of the two groups showed no significant statistically difference(P>0.05).2)The pattern of therapy of three tertiary hospitals included medical treatment(34.5%), thrombolytic therapy(9.0%) and PCI(56.5%). Reperfusion rate was 65.5%,rate of early reperfusion(thrombolytic therapy and primary PCI) was 25.2% in tertiary hospitals of Ningxia; the proportion of thrombosis was 9.0% , primary PCI was 16.2%.The pattern of therapy of four second-tier hospitals included medical treatment and thrombolytic therapy. Medical treatment ,such as application of aspirin, clopidogrel, ACEI/ARB,β-blocker, cholesterol lowering agents achieved the criterion of the corresponding period clinical epidemiology in large scale in our country.Conclusion:1) Thrombolytic therapy group is more beneficial than general treatment group in symptoms- relief. There is higher mortality rate in thrombolytic therapy group than primary PCI. There is higher incidence of malignant ventricular arrhythmia in primary PCI than elective PCI group.2) The pattern of therapy, reperfusion rate and rate of medicine usage in tertiary hospitals of Ningxia achieve the criterion with major cities in our country. The proportion of thrombolytic therapy is lower than the average level of country second-tier hospitals , rate of medicine usage have nearly reached standard.