Objective To analyze the application effect of the Guidelines for Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes (NSTE-ACS) in the departments of cardiovasology of local district hospitals, and study relevant influencing factors.Methods The medical materials were collected from 328 patients with NSTE-ACS hospitalized in the Department of Cardiovascular Diseases of People’s Hospital in Zengcheng District of Guangzhou City from Oct. 2014 to Aug. 2015. The accordance rate of the materials to the Guidelines (2012) was reviewed. The curative effects and complications incidence were compared between accordance group and non-accordance group by using chi-square test and t test. The relevant influencing factors were analyzed by using Logistic regression analysis.Results Among 328 medical records, 187 were fully in accordance with the Guidelines, the accordance rate was 57.01%, and the average age was (52.17±12.85) in accordance group, and other 141 medical records was not in accordance with the Guidelines, and the average age was (51.43±11.08) in non-accordance group. The comparison in clinical baseline level between 2 groups showed that the differences in age, sex and complications had no statistical significance (P>0.05). The recurrence rates of myocardial infarction/angina pectoris (P=0.005) and arrhythmia (P=0.038) were significantly lower, and hospitalization days (P=0.027) were significantly less in accordance group than those in non-accordance group. The intermediate title of physician was the risk factors influencing following the Guidelines (OR=1.545, 95%CI: 1.311~1.804,P=0.025), and postgraduate was the protective factor (OR=0.646, 95%CI:0.447~0.945,P=0.045).Conclusion The Guidelines can improve the therapeutic effect on coronary heart disease and reduce the incidence of complications and hospital staying time, but its application and population are still insufficient in local district hospitals. The physicians with intermediate titles and college/university degrees don’t have enough knowledge of the Guidelines, who should enhance learning.%目的：分析遵循指南的治疗在地方区级医院心血管内科的应用效果和相关影响因素分析。方法纳入2014年10月~2015年8月于广州市增城区人民医院心血管内科收治的非ST段抬高急性冠脉综合征患者328例的病历资料，评价其与2012年《非ST段抬高急性冠状动脉综合征诊断和治疗指南》的符合率，利用卡方检验或t检验比较符合指南的病历（符合组）和不符合指南的病历（未符合组）的治疗效果和并发症发生率差异，采用Logistic回归分析影响遵循指南治疗的因素。结果在这328份病历中，有187份完全符合指南，符合率为57.01%，该组的平均年龄为（52.17±12.85）岁，而另外141份则不符合或不全符合指南规定，平均年龄（51.43±11.08）岁，比较符合指南组和未符合组患者的临床基线水平，他们在年龄、性别、合并疾病等方面的差异无统计学意义（P＞0.05）。符合组心梗/心绞痛的再次发生率（P=0.005）、心律失常的发生率（P=0.038）均显著低于未符合组，而其住院天数显著短于未符合组（P=0.027）；医师中级职称是影响遵循指南应用的危险因素（OR=1.545，95%CI：1.311~1.804， P=0.025），而学历研究生为遵循指南应用的保护因素（OR=0.646，95%CI：0.447~0.945，P=0.045）。结论遵循指南的治疗可提高冠心病的治疗效果和减少并发症的发生及住院时间，但在地方区级医院的推广应用仍不足，中级职称和大专/本科学历医师对指南的认识和应用不够，应加强学习。
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