目的 研究急性冠脉综合征患者的医疗资源使用与医疗费用情况，为制定合理医疗政策，减轻社会及患者负担提供证据支持。方法 选取2012-2013年天津市城镇职工基本医疗保险参保人30%随机抽样数据库中至少1次以急性冠脉综合征为主要诊断的住院记录，年龄≥ 18周岁，基线期（12个月）和随访期（12个月）内均持续参保的患者为研究对象。统计基线期患者基本特征、随访期患者疾病特异的医疗资源使用及医疗费用构成，并通过广义线性回归分析患者医疗费用的影响因素。结果 14 358名患者纳入本研究中，患者平均年龄为（64.69±10.72）岁，54.6%为男性，80.6%处于退休状态。患者察尔森合并症指数为（1.72±1.63）。19.0%的患者因急性冠脉综合征有过住院经历，年均住院次数为（1.32±0.72）次，次均住院天数为（10.47±7.76）d。88.5%的患者因急性冠脉综合征有过门诊治疗经历，年人均门诊次数为（13.05±10.18）次。患者年均医疗总费用为（7 435±16 039）元，其中所占比例最高的分别是药品费用（53.3%）、医疗耗材费用（26.7%）和检查费用（10.2%）。回归结果显示年龄、性别、基线合并症及治疗方式是影响患者总医疗费用的主要因素。结论 急性冠脉综合征患者医疗费用较高，应采取有效措施降低急性冠脉综合征发生，制定合理医疗政策，从而减轻患者的经济负担。

Objective To study the utilization of medical resources and medical expenses of patients with acute coronary syndrome in order to provide evidence for formulating reasonable medical policies and reducing the burden of society and patients. Methods The subjects were selected from a random sampling database of 30% of urban employees' basic medical insurance insured in Tianjin from 2012 to 2013, which included at least one hospitalization record with acute coronary syndrome as the main diagnosis. The patients were over 18 years old, with continuous participation in the baseline (12 months) and follow-up (12 months). The basic characteristics of patients in the baseline period, the use of disease-specific medical resources and the composition of medical expenses in the follow-up period were analyzed. The influencing factors of patients' medical expenses were analyzed by generalized linear regression. Results A total of 14 358 patients were included, with mean age of (64.69 ±10.72) years and 45.4% female, and 80.6% patients were retired. Charlson Comorbidity Index was (1.72 ±1.63). 19.0% of patients had hospitalization experience due to acute coronary syndrome. And the average number of hospitalizations per year was (1.32 ±0.72) times, and the average number of hospitalization days per time was (10.47 ±7.76) d. 88.5% of patients had experience of outpatient treatment for acute coronary syndrome, and the average number of outpatient visits per year was (13.05 ±10.18) times. The average annual total medical expenses of patients with acute coronary syndrome were (7 435 ±16 039) CNY. Among them, the highest proportion was drug expenses (53.3%), medical consumables costs (26.7%) and inspection costs (10.2%). The regression results showed that age, sex, baseline complications and treatment methods were the main factors affecting the total medical expenses of patients with acute coronary syndrome. Conclusions Cost for patients with acute coronary syndrome was considerable. Effective measures should be taken to reduce the occurrence of acute coronary syndrome, and reasonable medical policies should be formulated to alleviate the economic burden of patients.