老年慢性心力衰竭合并不同程度肾功能不全患者临床治疗药物特点分析

Analysis on the feature of therapy drug in elderly chronic heart failure with varying degrees of renal dysfunction

目的 探讨研究老年慢性心力衰竭合并不同程度肾功能不全患者的临床治疗药物特点.方法 采取回顾性病例收集的方式选取解放军总医院2005年10月～2010年10月因慢性心力衰竭首次住院老年患者.将入选患者分为肾功能正常组、肾功能轻度下降组和肾功能中、重度下降组.统计分析比较三组肾功能分组的临床治疗药物特点.结果 三组药物使用率对比,ACEI类药物（59.7％、50.4％、42.9％）、β受体阻滞剂（47.2％、46.1％、37.0％）、利尿剂（55.1％、58.2％、74.8％）、螺内酯（40.3％、48.9％、57.1％）差异有统计学意义（P＜0.05或P＜ 0.01）.肾功能中、重度下降组与肾功能正常组及肾功能轻度下降组比较,ACEI类药物、β受体阻滞剂使用比例低,利尿剂、螺内酯使用比例高（P＜0.05或P＜ 0.01）.肾功能轻度下降组与肾功能正常组相比,ACEI类药物使用比例低,利尿剂使用比例高（P＜0.05、P＜ 0.01）.结论 老年慢性心力衰竭合并肾功能不全患者ACEI类药物、β受体阻滞剂使用比例低,利尿剂、螺内酯使用比例高.

Objective To study and research the feature of therapy drug in elderly chronic heart failure with varying degrees of renal dysfunction.Methods Elderly CHF patients who were first time admitted to General Hospital of PLA from October 2005 to October 2010 were applied with retrospective case analysis.Patients were divided into three groups：the normal renal function group,the mild renal function descend group,the moderate or severe renal function descend group,the feature of therapy drug was researched among the three groups.Results Compared among the three groups,the therapy drug proportion of ACEI （59.7％,50.4％,42.9％）,β-receptor （47.2％,46.1％,37.0％）,diuretic （55.1％,58.2％,74.8％）,Spironolactone （40.3％,48.9％,57.1％） were significant （P ＜ 0.05 or P ＜ 0.01）.Compared with the normal renal function group and the mild renal function damage group,the therapy drug proportion of ACEI,β-receptor blocker was lower and the proportion of diuretic,Spironolactone was higher in moderate or severe renal function descend group （P ＜ 0.05,P ＜ 0.01）.Compared with normal renal function group,the proportion of ACEI in the mild renal function descend group was lower,which of diuretic,Spironolactone was higher （P ＜ 0.05,P ＜ 0.01）.Conclusion The therapy drug proportion of ACEI,β-receptor blocker is lower in elderly chronic heart failure with renal dysfunction,and the proportion of diuretic is higher.