Abstract: Objective　To investigate the general practitioners’ treatment for patients after PCI in Pudong New Area,so as to explore the deficiencies in community treatment and ways of improvement.Methods　From July to September 2014,after stratifying in accordance with the located regions （urban,suburban and rural areas） of community health service centers in Pudong New Area,4 community health service centers were randomly selected from each layer,and from these centers,363 general practitioners（GPs） with clinical experience of more than two years were investigated by self-developed questionnaire based on Chinese Percutaneous Coronary Artery Intervention Guidelines 2012.The questionnaire covered three areas:drug therapy,treatment of concomitant diseases,follow-up and health education.A total of 363 questionnaires were handed out and 362 valid ones were recovered with an effective response rate of 99.7%.Results　Drug therapy:the ratio of aspirin prescribed by 160（44.2%） GPs was 31%～60%;190（52.5%）GPs heard of clopidogrel,but did not know its role;238（65.7%）GPs had not heard of dual antiplatelet therapy;the ratio of statins prescribed by 170（46.0%）GPs was more than 60%;238（65.7%）GPs did not know the target value of LDL-C;the ratio of β-blockers prescribed by 296（81.8%）GPs was 10%～30%;the ratio of ACEI/ARB prescribed by 318（87.8%） GPs was 10%～30%.The differences in prescription ratios of aspirin,statins,β-blockers and ACEI/ARB,degree of understanding clopidogrel,dual antiplatelet therapy and target value of LDL-C among GPs with different professional and technical titles showed statistically significance （P<0.05）.Treatment of concomitant diseases:150（41.4%）GPs would first prescribe β-blockers and/or ACEI/ARB for patients with concurrent hypertension;226（62.4%）GPs would strictly control other risk factors for those with concurrent diabetes.The differences in the choice of drugs for the treatment of concurrent hypertension and strict control of other risk factors for the treatment of concurrent diabetes between GPs with different professional and technical titles showed statistically significance （P<0.05）.Follow-up and health education:260（71.8%）GPs advised patients to stop smoking in the first visit,only 1（0.4%）GP could do so in each visit.The differences in the propaganda of tobacco control for smoking patients between GPs with different professional and technical titles were statistically significant （P<0.05）.For regular assessment of the patients’ clinical and prognostic conditions,239（66.0%）GPs selected laboratory examination,356（98.3%）GPs selected electrocardiogram,65（18.0%）GPs selected echocardiography,21（5.8%）GPs selected exercise testing.The differences in the choice of laboratory examination and electrocardiogram for regularly assessing the patients’ conditions between GPs with different professional and technical titles were statistically significant（P<0.05）,while those in the choice of electrocardiogram and exercise testing were not（P>0.05）.Conclusion　The GPs in Pudong New Area manage well in the prescription ratio of aspirin and statins in the PCI postoperative treatment,but poorly in other drugs,treatment of concomitant diseases,propaganda of tobacco control and regular assessment suggested by the guideline of PCI,therefore,they need to further study the guideline and actively study the new progress and theories related to coronary artery disease.

Key words: General practitioners, Patients after percutaneous coronary intervention, Community treatment, Pudong New Area

摘要： 目的　了解浦东新区全科医生对经皮冠状动脉介入（PCI）术后患者的治疗情况，探讨社区治疗中的不足及改进方法。方法　于2014年7—9月，在浦东新区按社区卫生服务中心坐落的地域（城区、城郊结合区、郊区）进行分层，每层随机抽取4家社区卫生服务中心，对该中心所有临床工作2年以上的全科医生进行调查，共363例。结合《2012中国经皮冠状动脉介入治疗指南》自拟问卷，内容主要分为3部分：药物治疗、伴发疾病的治疗、随访和健康宣教。共发放问卷363份，回收有效问卷362份，有效回收率为99.7%。结果　药物治疗情况：160例（44.2%）全科医生阿司匹林的使用比例为31%～60%；190例（52.5%）全科医生听说过氯吡格雷，但是不知晓其作用；238例（65.7%）全科医生从未听说过双联抗血小板治疗；170例（46.0%）全科医生他汀类药物的使用比例>60%；238例（65.7%）全科医生不知晓低密度脂蛋白胆固醇（LDL-C）的目标值；296例（81.8%）全科医生β-受体阻滞剂的使用比例为10%～30%；318例（87.8%）全科医生血管紧张素转化酶抑制剂（ACEI）/血管紧张素Ⅱ受体拮抗剂（ARB）的使用比例为10%～30%；不同职称全科医生对阿司匹林、他汀类药物、β-受体阻滞剂、ACEI/ARB的使用比例及氯吡格雷、双联抗血小板治疗、LDL-C目标值的了解掌握情况间差异均有统计学意义（P<0.05）。对伴发疾病的治疗情况：150例（41.4%）全科医生对伴发高血压的患者会优先考虑β-受体阻滞剂和/或ACEI/ARB；226例（62.4%）全科医生会严格控制伴发糖尿病患者的其他危险因素；不同职称全科医生对伴发高血压的药物选择情况、伴发糖尿病的治疗在严格控制其他危险因素的选择情况间差异有统计学意义（P<0.05）。随访和健康宣教情况：260例（71.8%）全科医生只在吸烟患者初诊时做戒烟宣教，仅1例（0.4%）全科医生在吸烟患者每次就诊时均做戒烟宣教，不同职称全科医生对吸烟患者的戒烟宣教情况间差异有统计学意义（P<0.05）；239例（66.0%）全科医生对患者定期进行实验室检查，356例（98.3%）对患者定期进行心电图检查，65例（18.0%）对患者定期进行心脏超声检查，21例（5.8%）对患者定期进行运动试验检查；不同职称全科医生对患者定期进行实验室检查、心脏超声检查间差异有统计学意义（P<0.05），而心电图检查、运动试验检查间差异无统计学意义（P>0.05）。结论　在PCI术后治疗中，浦东新区全科医生对阿司匹林、他汀类药物使用比例掌握较好，对指南推荐使用的其他药物、伴发疾病治疗、戒烟宣教、定期评估方面掌握欠佳，因此需要深刻理解指南，积极学习新进展、新理论。

关键词: 全科医生, 经皮冠状动脉介入术后患者, 社区治疗, 浦东新区