2011—2017年中国心肌梗死治疗质量的趋势与变异

doi:10.3969/j.issn.1006-5253.2021.02.001

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摘要目的分析2011—2017年急性ST段抬高型心肌梗死（STEMI）治疗质量评价指标使用率变化趋势；计算急性心肌梗死治疗质量综合得分，获得综合质量变化趋势及变异，为改善STEMI治疗质量提供依据。方法选择STEMI治疗指南Ⅰ类推荐的STEMI治疗质量评价指标12项，提取单病种监测系统中STEMI患者的数据；计算STEMI评价指标使用率；利用分母权重法获得治疗质量综合得分及变异，并进行趋势性检验。结果与2011年相比，12项治疗质量指标中，到医院90 min内实施经皮冠状动脉介入治疗使用率增幅最大，到达医院后即刻使用β受体阻滞剂使用率下降最大，趋势性检验有统计学意义；2011年至2017年间，医院综合得分中位数随时间变化不明显，四分位数间距随时间有增大趋势。结论我国STEMI的多数治疗质量指标使用率显著改善；医院综合治疗得分趋势稳定，但医院间变异扩大。

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	栗景坤
	王心雨
	李习
	王超
	刘美娜

关键词 ：急性ST段抬高型心肌梗死, 治疗质量指标, 综合得分, 趋势及变异

Abstract：Objective To analyze the trend of utilization rate of treatment quality evaluation index for ST-segment elevation myocardial infarction (STEMI) from 2011 to 2017; to calculate the comprehensive treatment quality score of acute myocardial infarction to obtain the variation trend and variation of the comprehensive quality, and to provide evidence for improving the quality of STEMI treatment. Methods Twelve STEMI treatment quality evaluation indicators which were recommended by I kind in STEMI treatment guidelines were selected, and data of STEMI patients were extracted from the singledisease surveillance system to calculate the utilization rate of the STEMI treatment evaluation indicator. The denominator weighting method was used to obtain the comprehensive score and variation of treatment quality, and the trend test was conducted. Results Compared with 2011, among the 12 treatment quality indicators, the utilization rate of PCI within 90 min of hospital arrival increased the most, and the use rate of beta blockers immediately after hospital arrival decreased the most, showing a statistically significant trend test. Between 2011 and 2017, the comprehensive score of hospitals did not change obviously with time, but the interquartile interval increased with time. Conclusion The utilization rate of most of the treatment quality indexes of STEMI in China has been significantly improved; the trend of hospital comprehensive score was stable, but the variation between hospitals was enlarged.

Key words： acute ST-segment elevation myocardial infarction treatment quality index composite score trend and variation

收稿日期: 2020-09-22

基金资助:国家自然科学基金（81573255）

通讯作者: 刘美娜，Email: liumeina369@163.com

引用本文:

栗景坤，王心雨，李习，王超，刘美娜. 2011—2017年中国心肌梗死治疗质量的趋势与变异[J]. 中国医院统计, 2021, 28(2): 97-100.
Li Jingkun, Wang Xinyu, Li Xi, Wang Chao, Liu Meina. Trends and variations of myocardial infarction treatment quality in China from 2011 to 2017. journal1, 2021, 28(2): 97-100.

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