绵阳市慢性心力衰竭住院患者药物治疗现状分析

目的了解绵阳市慢性心力衰竭患者药物治疗动态,初步分析用药合理性。方法采用绵阳市3所医院1998、2001和2004年住院慢性心力衰竭患者病历数据库,对慢性心力衰竭患者使用药物治疗状况进行调查分析。结果绵阳市三家医院上述3年慢性心力衰竭患者共有1882人。1998年、2001年和2004年药物使用率分别是:利尿剂63.7%→68.1%→74.5%;洋地黄类40.2%→42.4%→67.9%;ACEI/ARB(血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂)18.2%→30.3%→57.1%;β-b locker(β受体拮抗剂)14.9%→31.2%→60.1%;硝酸盐类42.5%→48.2%→56.3%;非洋地黄类正性肌力药物25.7%→28.9%→20.7%;钙离子拮抗剂17.5%→18.3%→20.1%。不使用-βb locker的主要原因是窦性心动过缓。不使用ACEI/ARB的主要原因是低血压。未考虑使用β-b locker占不用原因的32.6%,未考虑使用ACEI/ARB占不用原因的34.6%。结论提示自心力衰竭治疗指南公布以来,绵阳市心力衰竭患者规范化药物治疗水平有了明显提高。

Analysis on the Using Status of Medicaments for Chronic Heart Failure in the City of Mianyang

Objective To make a detailed survey of the status for medicine using for chronic heart failure(CHF) in Mianyang City.Methods By utilizing the medical history database of the patients of three municipal hospitals in the year of 1998,2001 and 2004,the status of drug using for the treatment of CHF patients were analyzed.Results There were total of 1882 patients with CHF in the year of 1998,2001 and 2004.The status of used medicaments is described.For diuretics,the using rate was 63.7,68.1 and 74.5% in 1998,2001 and 2004,respectively;For digitalis,the data was 40.2%,42.4% and 67.9%;for angiotensin-converting enzyme inhibitors/angiotensin Ⅱ receptor blocker(ACEI/ARB) 18.2%,30.3%,57.2%;forβ-blocker 4.9%,31.2%,60.1%;For nitrate,the data was 42.5%,48.2%,70.3%;for non-digitalis positive inotropic drugs 25.7%,28.9%,14.7% and 17.5%,18.3%,20.1% for calcium channel blocker(CCB).The patients with sinus bradycardia excluded the using of β-blocker and the patients with hypotensive excluded ACEI/ ARB.Those patients who did not consider using β-blocker amounts to about 32.6% of those who did not using β-blocker and the corresponding situation for ACEI/ARB is 34.6%.Conclusion The criterion situation for using medicaments for CHF in Mianyang has been improved since the therapy guild for CHF was issued but there is a gap between our status and that of developed countries.