基层医院慢性心力衰竭药物治疗现状及规范化治疗研究

Study on pharmacotherapy status and standardized treatment of chronic heart failure in primary hospital

目的研究基层医院慢性心力衰竭(CHF)药物治疗现状以及规范治疗。方法调查168例CHF患者药物治疗现状,按照随机分组原则分为观察组(96例)和对照组(72例),观察两组患者心功能改善情况、CHF病死率、总病死率、住院次数及住院时间等。结果基层医院治疗CHF主要药物为地高辛和利尿剂,地高辛的使用率为76.2%,利尿剂的使用率达86.3%,血管紧张素转换酶抑制剂的使用率为57.7%,能够达到靶剂量的仅为5.4%,β受体阻滞剂的使用率为27.4%,而达到靶剂量的仅占1.2%,螺内酯使用率为35.7%。观察组治疗总有效率为91.7%,对照组总有效率为56.9%,两组差异有高度统计学意义(P<0.01);观察组CHF病死率、平均住院次数、平均住院时间均少于对照组,差异有统计学意义(P<0.05)。结论基层医院CHF药物治疗现状急需改善,应加强对CHF患者的规范治疗,提高我国基层医院CHF药物治疗水平,增加CHF患者生存率,改善CHF患者预后。

Objective To study the pharmacotherapy status and standardized treatment of chronic heart failure（CHF） in primary hospital.Methods 168 cases of patients with CHF were randomly divided into the observation group（96 cases） and the control group（72 cases）.The cardiac function improvement,CHF mortality rate,total mortality rate,number of hospitalizations,hospital stays and other indexs were observed.Results In primary hospital,Digoxin and Diuretics were the main drugs in the treatment of CHF,of which the utilization rate was 76.2% and 86.3% respectively.The utilization rate of ACEI was 57.7%,of which only 5.4% could reach the target dose.The utilization rate of β-blocker was 27.4%,of which only 1.2% could achieve the target dose.The utilization rate of Spironolactone was 35.7%.The total effective rate was 91.7% in the observation group and 56.9% in the control group,the difference was statistically significant（P 〈0.01）;the CHF mortality,average number of hospitalization and average hospital stays of the observation group were lower than those of the control group,the differences were statistically significant（P 〈0.05）.Conclusion In primary hospital,the pharmacotherapy status of CHF is in urgent need of improvement,therefore,the hospital should strengthen the standardized treatment of CHF,improve CHF pharmacotherapy level of primary hospital in China,increase survival rate of patients with CHF and improve prognosis of CHF.