607例慢性心力衰竭住院患者的诊治分析

目的分析10年来慢性心衰住院患者药物治疗的变化情况,了解临床治疗与心衰指南的差距。方法回顾分析1999年～2008年10年间住院慢性心衰患者607例的临床资料,将10年来心衰药物治疗的构成百分率分前5年,后5年作比较,了解近年来慢性心衰的药物治疗演变情况。结果慢性心衰患者在住院时应用利尿剂类药前后5年使用均达90%左右,无明显变化(P>0.05);洋地黄类药使用率及大剂量洋地黄类使用率分别从前5年68.3%,11.1%下降到后5年的58.8%和6.6%(P<0.05);ACEI的使用率及达靶剂量ACEI类的使用率分别从前5年的65.9%,1.05%增长到后5年的81.9%,6.56%(P<0.01);β受体阻滞剂的使用率及达靶剂量β受体阻滞剂的使用率分别从前5年的17.1%、0.69%增长到后5年的46.56%和4.06%(P<0.01);螺内酯使用率从前5年的35.89%增长到51.56%,变化明显(P<0.01)。结论慢性心力衰竭的治疗有了明显变化,但临床实践与心衰指南仍有较大差距。

Objective To analyze the methods and changes in therapy of hospitalized patients with chronic heart failure during recent 10 years,to understand the differences between clinical treatment and heart failure guidelines.Methods I will analyze clinical data for 607 cases of hospitalized patiends with chronic heart failure from 1999 to 2008.I will compare percentage of drugs for chronic heart failure before five years with after five years in recent ten years in order to understand the changable situation of drugs for chronic heart failure in recent years.Results It is that patients of chronic heart failure in hospital for using diuretic reach to 90%,there is no obvious change （p0.05）;utilization rate of digitalis such a strong heart medicine from 68.3% before five years to 58.8% after five years;utilization rate of large doses with digitalis from 11.1% before five years to 6.6% after five years;utilization rate of ACEI and the dose ACEI from 65.9% before five years to 81.9% after five years or 1.05% before five years to 6.56% after five years （p0.01）;utilization rate of β-blocker and dose β-blocker from 17.1% before five years to 46.56% after five years or 0.69% before five years to 4.06% after five years （p0.01）;utilization rate of spironolactone from 35.89% before five years to 51.56% after five years（p0.01）.Conclusion I find that the treatment of chronic heart failure changes significantly.But there is still a wide gap between heart failure and clinical practice.