發(fā)布時間：2019-07-21 07:01

【摘要】：目的調(diào)研不同年齡段冠心病心衰患者臨床特征和出院醫(yī)囑用藥情況。方法調(diào)取2011年1月至2015年12月從該院心內(nèi)科出院明確診斷為冠心病并慢性心衰病例208例,回顧性分析其臨床特點,并對比研究不同年齡段藥物應(yīng)用與性別、紐約心臟病(NYHA)心功能分級、射血分?jǐn)?shù)的關(guān)系。結(jié)果既往并發(fā)癥前三位為高血壓130例(62.5%),心肌梗死112例(53.8%),2型糖尿病90例(43.3%);治療藥物總體應(yīng)用比例為:他汀類88.9%,硝酸酯類78.8%,阿司匹林73.1%,β受體阻滯劑62.0%,利尿劑67.3%,醛固酮拮抗劑(MRA)57.2%,地高辛36.1%,其中神經(jīng)內(nèi)分泌拮抗劑血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)/血管緊張素Ⅱ拮抗劑(ARB)、β受體阻滯劑、MRA三類藥物兩者合用比例40.4%,三者合用僅18.8%。年齡75歲組阿司匹林使用率高于年齡≥75歲組,而氯吡格雷、ARB、利尿劑、鈣離子拮抗劑(CCB)均在年齡≥75歲組使用率更高,除利尿劑女性應(yīng)用多于男性,其余各藥物使用率在性別上無顯著差異;阿司匹林、他汀類在NYHAⅠ/Ⅱ級組使用率高,氯吡格雷、利尿劑、MRA、地高辛的使用率在NYHAⅢ/Ⅳ級組高,ARB、CCB在射血分?jǐn)?shù)正常組應(yīng)用高于射血分?jǐn)?shù)減低組(LVEF50%),MRA、地高辛在射血分?jǐn)?shù)減低組應(yīng)用偏多。結(jié)論抗血小板聚集類、他汀、利尿劑、硝酸酯在冠心病合并慢性心衰患者使用率高,總體應(yīng)用規(guī)范,尤其是≥75歲者更規(guī)范,但是β受體阻滯劑、ACEI/ARB、MRA神經(jīng)內(nèi)分泌拮抗劑使用比例低,與指南有差距,對于冠心病合并慢性心衰的治療仍需要繼續(xù)規(guī)范化,加強醫(yī)師培訓(xùn)及患者依從性的教育。
[Abstract]:Objective to investigate the clinical characteristics and discharge orders of patients with coronary heart disease and heart failure in different age groups. Methods 208 patients with coronary heart disease complicated with chronic heart failure were diagnosed from the Department of Cardiology from January 2011 to December 2015. The clinical features were analyzed retrospectively, and the relationship between drug use and sex, (NYHA) cardiac function grade and ejection fraction in New York heart disease was compared. Results the first three complications were hypertension in 130 cases (62.5%), myocardial infarction in 112 cases (53.8%) and type 2 diabetes mellitus in 90 cases (43.3%). The overall proportion of therapeutic drugs was as follows: statins 88.9%, nitrate 78.8%, aspirin 73.1%, 尾 receptor blockers 62.0%, diuretics 67.3%, aldosterone antagonist (MRA) 57.2%, digoxin 36.1%, neuroendocrine antagonist angiotensin converting enzyme inhibitor (ACEI) / angiotensin II antagonist (ARB), 尾 receptor blocker, The proportion of MRA three kinds of drugs was 40.4%, and that of the three drugs was only 18.8%. The utilization rate of aspirin in 75-year-old group was higher than that in 鈮，

本文編號：2516997