582例慢性心力衰竭患者治疗状况回顾性分析

Retrospective analysis of 582 inpatients with chronic heart failure

目的:了解慢性心力衰竭(心衰)临床实际治疗与指南的差距。方法:回顾分析我科2006-2011年582例慢性心衰住院患者病例资料,按我国第2版心衰指南颁布时间(2007-12-30)为界,分成两组比较,组1为指南颁布前病例,组2为指南颁布后病例,了解慢性心衰临床治疗的实际情况。结果:我科慢性心衰住院患者以心肌病(48.8%)及高血压病(38.7%)为主;心功能分级以NYHAⅢ级(56%)为主;组1和组2的ACEI(血管紧张素转化酶抑制剂)/ARB(血管紧张素受体抑制剂)、β-受体阻滞剂、醛固酮受体拮抗剂及利尿剂靶剂量使用率分别为45.9%/46.6%、0.6%/1.4%、83.4%/85.9%、54.1%/51.3%。器械治疗中CRTD的植入率两组分别为0.6%/5.6%(P<0.01)。结论:我科ACEI/ARB、β-受体阻滞剂和利尿剂的靶剂量使用率较低,器械治疗比例呈上升趋势,临床实际与指南规范存在差距。

Objective：To investigate the gap between the clinical treatment and guidelines in patients with chronic heart failure. Method：Five hundred and eighty-two cases with chronic heart failure hospitalized in our department from 2006 to 2011 were analyzed retrospectively.We divided these cases into two groups,according to the latest heart failure guidelines issued（December 30,2007） and understanded the actual situation of the clinical treatment in recent years. Result：The target dose utilization rate in two groups of ACEI/ARB,beta-receptor blockers,aldosterone receptor antagonist and diuretic agent were 45.9%/46.6%,0.6%/1.4%,83.4%/85.9%,54.1%/51.3%,respectively.The device therapy of CRTD implantation rates in two groups were 0.6%/5.6%（P0.01）. Conclusion：The utilization of target does of ACEI/ARB,beta-blockers and diuretic agent is below the guidelines.The device theary proportion is rising.