慢性心力衰竭住院病例药物治疗的回顾性调查

马金萍; 王林; 党群; 李永健; 李喜元; 张承宗; 李广平

Abstract

马金萍,王林,党群,李永健,李喜元,张承宗,李广平.慢性心力衰竭住院病例药物治疗的回顾性调查[J].Chinese journal of Epidemiology,2007,28(1):78-82

慢性心力衰竭住院病例药物治疗的回顾性调查

Retrospective analysis of drug treatment on inpatients with chronic heart failure

Received:April 20, 2006

DOI：

KeyWord: 慢性，心力衰竭住院病例药物治疗

English Key Word: Chronic heart failure Inpatients Drug treatment

FundProject:天津市科委重点基金资助(033111311)

Author Name	Affiliation	E-mail
MA JINping	Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
WANG Lin	Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China	wang.1in@medmail.com.cn
DANE Qun	天津市第一中心医院
LI Yongjian	天津市第一中心医院
LI Xiyuan	Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
ZHANG Chengtong	Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
LI Guangping	Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China

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Abstract:

目的了解慢性心力衰竭(心衰)住院病例治疗药物在30年来的应用情况。方法采用两中心、回顾性研究。对药物治疗在年代、性别、年龄、心功能和病因等的分布进行分析。结果入选5189例次，男女比为1：1．02(P>0．05)。平均年龄(62．93±13．49)岁。临床诊断依次是冠心病(44．2％)、风湿性心脏病(24．1％)、肺心病(19．0％)、扩张型心肌病(4．8％)等。人院时心功能以纽约心功能分级(NYHA)Ⅲ级、Ⅳ级为主，分别为40．6％和44．5％。治疗药物总体应用比例为硝酸酯类80．0％、利尿剂71．8％、洋地黄制剂68．1％、血管紧张素转换酶抑制剂(ACEI)52．2％和p．受体阻滞剂19．5％，上述药物的应用逐年代增加。肺心病心衰病例的主要治疗药物也是硝酸酯类、利尿剂、洋地黄制剂。男性应用ACEI多于女性，≥60岁患者应用ACEI和血管紧张素受体拮抗剂(ARB)的比例多于<60岁年龄组，B一受体阻滞剂的应用则无性别和年龄差异。结论慢性心衰住院病例的治疗药物以利尿剂、硝酸酯制剂和洋地黄制剂等为主；ACEI和8一受体阻滞剂的应用增加迅速，虽未达到“指南”的要求，但显示了治疗观念的变化。

English Abstract:

Objective To investigate drug treatment of inpatients with chronic heart failure(CHF)during the past 30 years in some areas and to provide more information on the treatment strategy of CHF.Methods In two centers a retrospective study was conducted. All data were taken from the hospitalizedcases with chronic heart failure. The medication distributions in different decade,gender,age heart functiongrade and etiology were analyzed. Results 5189 cases were enrolled with the ratio of male to female as1:1. 02. The mean age was ( 62. 93士13.49) years old. The general causes of chronic heatt failure were asfollows: coronary heart disease(44.2%)，rheumatic heart disease ( 24. 1%)，pulmonary heart disease(19.00,6)and cardiomyopathy (4.8%).The admission cardiac function was mostly seen as grade NYHAⅢ and Ⅳ，and their proportions were 40.6 0.6 and 44.5.Major medication would include nitride(80.0%)，diuretics(71.8%)，digitalis(68.1%)，angiotensin conversion enzyme inhibitors(ACEI)(52. 2 %)andβ-blockers(19. 5 %)etc. Moreover the frequency of above used medication was essentiallyincreasing decade by decade. The major drug treatment of pulmonary heart disease also included diuretics,nitride, digitalis. ACEI was more commonly used in male than in female cases. The frequency of ACEI andARB were more commonly used in the group ≥60 years old than that in the group<60 years old. Theadministration frequency of β一blockers had no significant difference among different age and sexesConclusion The conventional drugs such as nitride,diuretics,digitalis were still dominated the treatment ofCHF.Although the administration frequency of ACEI and (3-Mockers increased quickly,there had been agreat gap between the optimal medical strategy and clinical practice in the management of CHF. Datashowed the treatment strategy was changing.

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