基层医院不同时间段慢性心力衰竭患者病因和药物治疗状况分析

The retrospective studies of etiology and pharmaceutical therapy in hospitalized patients with congestive heart failure in primary hospital in different periods

目的 了解不同时间段慢性心力衰竭（CHF）患者病因及药物治疗状况.方法 调查我院1998-2000年度段和2008-2010年度段住院诊断为CHF患者的病史资料,比较不同年度段CHF患者病因及药物治疗状况.结果 CHF主要病因由风心病、冠心病和高血压演变为冠心病、高血压和风心病（P＜0.05）.住院期间症状明显改善率及好转率均升高（P＜0.05）,住院病死率明显下降（P＜0.01）.两组患者住院期间治疗CHF的药物仍以利尿剂、硝酸酯类和洋地黄类制剂为主,洋地黄使用率呈明显下降趋势（54.10%比33.50%,P＜0.01）,β受体阻滞剂（14.80%比60.20%,P＜0.01）和血管紧张素转换酶抑制剂（ACEI）（16.10%比75.30%,P＜0.01）应用明显上升.结论 CHF患者主要病因由风心病演变为冠心病,CHF治疗药物以传统药物为主,但β受体阻滞剂、ACEI及螺内酯的应用明显增加.

Objective To investigate the information of etiology and pharmaceutical therapy of hospitalized patients with CHF during different time periods. Methods To analysis of evolution and status in the etiology and drug treatment of hospitalized patients with CHF during the years of 1998-2000 and 2008-2010. Results The major cause of CHF shifted significantly from rheumatic valvular disease to coronary heart disease （P〈0.05）.Symptoms of markedly improved rates and improved rates increased （P〈0.05）, hospital mortality decreased significantly （P〈0.01） during hospitalization. The medical treatment mainly remained conventional. Rate of digitalis was significantly decreased （54.10% vs 33.50%）, β-blockers （14.80% vs 60.20%） and ACEI （16.10% vs 75.30%） application significantly increased. Conclusion The etiology of CHF shifts significantly and coronary heart disease has become the leading cause of HF during the past one decades. Drug treatment of CHF based on traditional medicines, but application of β-blockers, ACEI and spironolactone significantly increased.