绵阳市慢性心力衰竭患者β-受体阻滞剂使用情况动态分析

Analysis of the Use of β-Blocker for Chronic Heart Failure in the City of Mianyang

目的了解绵阳市心力衰竭患者β-受体阻滞剂(β-B locker)使用情况。方法采用绵阳市3所医院1998年、2001年和2004年住院慢性心力衰竭(CHF)患者病历数据库,对CHF患者-βB locker使用情况进行回顾性调查研究。结果绵阳市上述3年心力衰竭患者共1882人。其中使用β-b locker者共计625人,占总心衰患者的33.21%;1998年、2001年和2004年使用β-b locker的患者占当年CHF住院患者总数的比例逐渐增加(p<0.01)。出院时建议使用-βb locker的比例逐渐增加(p<0.01)。β-b locker的选择在1998年以美托洛尔为主,2001年和2004年-βb locker的种类明显增多,且倍他乐克比例逐渐下降,但仍为各种药物之首。选用倍他乐克的患者住院死亡率明显降低。结论提示自从心力衰竭治疗指南公布以来,绵阳市心力衰竭患者-βb locker的使用水平逐渐提高,但与欧美发达国家比较尚有一定差距。

Objective To make a detailed survey of the status for medicine using on 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 is been analyzed. Results There were 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% ; for β - 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 were not used with β - blocker and the corresponding situation for ACEI/ARB is 34.6%. Conclusion The criterion situation for medicaments for CHF in Mianyang has been improved since the therapy guild for CHF was issued but these is a gap between our status and that of developed countries.