MEDICAL-MANAGEMENT AND THE DECLINE IN MORTALITY FROM CORONARY HEART-DISEASE
MEDICAL-MANAGEMENT AND THE DECLINE IN MORTALITY FROM CORONARY HEART-DISEASE
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DOI：
10.1136/bmj.292.6512.33
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发表时间：
1986-01-04
影响因子：
105.7
通讯作者：
BEAGLEHOLE, R
中科院分区：
文献类型：
--
作者：
BEAGLEHOLE, R
利用几项基于人群的研究数据，评估了1974年至1981年奥克兰入院前复苏、冠心病监护室、心肌梗死后β受体阻滞剂治疗、冠状动脉搭桥手术和高血压治疗对冠心病死亡率下降的贡献。1981年，奥克兰70岁以下人群死于冠心病的人数比1974年的预期人数少了126人。在减少的126例死亡中，具体的医疗干预可能占约51例（40%）。当地数据表明，入院前的复苏是造成126例死亡病例中20例（16%）的原因。根据本地数据和海外试验所作的预测显示，在减少的126名死亡个案中，有多达15名（12%）是因治疗高血压而死亡。冠心病监护病房和心肌梗死后β受体阻滞剂的使用估计分别导致126例死亡中的6例（5%）和3例（2%）。在缺乏适当的随机对照试验数据的情况下，冠状动脉手术的影响尤其难以确定。在减少的126例死亡中，估计其贡献范围为7至23例（5%至18%）。
The contribution of resuscitation before admission to hospital, coronary care units, treatment with beta blockers after myocardial infarction, coronary artery bypass surgery, and the treatment of hypertension to the decline in mortality from coronary heart disease in Auckland between 1974 and 1981 was assessed by using data from several population based studies. There were 126 fewer deaths from coronary heart disease in Auckland in 1981 than expected from the 1974 rates among people less than 70 years. The specific medical interventions probably accounted for about 51 (40%) of the 126 fewer deaths. Local data indicate that resuscitation before admission to hospital was responsible for 20 (16%) of the 126 fewer deaths. Projections based on local data and trials carried out overseas suggest that up to 15 (12%) of the 126 fewer deaths were due to the treatment of hypertension. Coronary care units and the use of beta blockers after myocardial infarction were estimated to be responsible for six (5%) and three (2%) of the 126 fewer deaths, respectively. The impact of coronary surgery was especially difficult to determine in the absence of appropriate randomised controlled trial data. Estimates of its contribution ranged from seven to 23 (5% to 18%) of the 126 fewer deaths.