心筋梗塞、脳卒中発症後の高血圧と高脂血症の治療の実際:再発予防の現状

心梗、脑卒中后高血压、高脂血症的治疗实战：预防复发现状

• 批准号: 12770194
• 负责人: 松井 邦彦
• 金额: $ 1.54万
• 依托单位: Kyoto University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12770194/
• 关键词: 急性心筋梗塞; 脳卒中; β遮断薬; アスピリン; 血圧; 血清コレストロール値; 心筋梗塞; 三次予防

平成11年1月より12月までの期間に、教育病院3施設に急性心筋梗塞の診断で入院し、生きて退院した患者139名、および、1施設に脳卒中(脳梗塞、脳出血)の診断で入院し、生きて退院した患者41名を対象として、カルテ調査を行った。急性心筋梗塞の患者では、65%が男性で、全体の平均年齢は67歳だつた。退院時の平均血圧は121/70mmHgで、平均血清コレステロール値は172mg/dlだった。この中で一年後が確認できたのは82%であり、一年後の平均血圧は132/76mmHgで、平均血清コレステロール値は188mg/dlだった。脳卒中の患者では、46%が男性で、全体の平均年齢は68歳だった。退院時の平均血圧は131/72mmHgで、平均血清コレステロール値は178mg/dlだった。一年後の確認ができたのは39%であり、一年後の平均血圧は125/76mmHgで、平均血清コレステロール値は202mg/dlだった。このように、血圧と血清コレステロール値のコントロールについては、急性心筋梗塞および脳卒中の思者瑳ともに、比較的良好になされていた。一方、急性心筋梗塞の患者では、生命予後の改善効果がフンダム化比較試験により示されている、β遮断剤やアスピリンが退院時に処方されているものは、それぞれ12%と78%であった。また、硝酸薬は70%、HMG-CoA還元酵素阻害薬は22%に処方されていた。β遮断剤が処方されている患者の割合は、欧米諸国と比較して著しく低いと考えられた。一年後でも、β遮断剤14%、アスピリン70%と、同様の処方率であった。硝酸薬は63%、HMG-CoA還元酵素阻害薬は24%に処方されていた。再発率に関しては、経過観察中の欠損例が多いために、明らかにすることはできなかった。今後、日本における根拠に基づいた医療の普及に関し、β遮断薬の処方率が低い理由の解明など、更なる調査、研究が必要と考えられた。

There were 139 patients with acute myocardial infarction, 139 patients with acute myocardial infarction, 139 patients with acute myocardial infarction, 1 patient with stroke, 41 patients with acute myocardial infarction, 41 patients with acute myocardial infarction, 41 patients with acute myocardial infarction, 139 patients with acute myocardial infarction, 139 patients with acute myocardial infarction, 41 patients with acute myocardial infarction in Pingcheng and 41 patients with acute myocardial infarction in Pingcheng Hospital. Acute myocardial infarction "patients", 65% "male", the average age of all "67 years". At the time of discharge, the average blood 121/70mmHg and serum concentration were significantly higher than those of the control group (P < 0.01). The average serum concentration was significantly higher than that of the control group (P < 0.01). The average serum concentration was significantly higher than that of the control group (P < 0.01). The average serum concentration was significantly higher than that of 172mg/dl. One year later, it was confirmed that the average blood 132/76mmHg was 82%, and the average serum concentration was significantly higher than that of the control group. The average serum concentration was significantly higher than that of the control group (P < 0.01). One year later, the average serum concentration was significantly higher than that of normal control. "Stroke" patients ", 46%" male ", all" average age "68 years old. At the time of discharge, the average blood 131/72mmHg and serum concentration were significantly higher than those of the control group (P < 0.01). The average serum concentration was significantly higher than that of the control group (P < 0.01). The average serum concentration was significantly higher than that of the control group (P < 0.01). The average serum concentration was significantly higher than that of 178mg/dl. One year later, we confirmed that 39% of the patients were infected. One year later, the average blood samples were 125/76mmHg, and the average serum samples were 202mg/dl. The blood, blood, serum, blood, blood On the one hand, the patients with acute myocardial infarction were suffering from acute myocardial infarction, and the results of life improvement were significantly higher than those of patients with acute myocardial infarction and those with acute myocardial infarction on the one hand, patients with acute myocardial infarction, patients with acute myocardial infarction and patients with acute myocardial infarction. HMG-CoA zymozymes block 22% of the total infestation. The patients were cut off by β-occlusion, and the omega-state was lower than the control group. One year later, 14% of the patients were cut off by β-occlusion, 70% by β-occlusion, and the same rate by the same prescription. Sixty-three percent of nitrate and HMG-CoA zymozymes blocked 24 percent of the compounds. The rate of failure is much higher than that of other cases in the review. In the future, in Japan, the root cause of the disease is the popularization of medicine, the prescription rate of β-blocking, the low rate of medical treatment, and the reason for the low rate of medical treatment.