上海市稳定性心力衰竭患者药物治疗现状调查

Corss-sectional survey on the current status of drug therapy in patients with stable heart failure in Shanghai

目的 临床试验证实血管紧张素转换酶抑制剂 (ACE I)和 β 受体阻滞剂能改善慢性心力衰竭患者的预后 ,但是并非所有适合使用的患者均已得到此类药物的治疗。为了了解上海市慢性稳定性心力衰竭患者的病情和药物治疗情况 ,我们进行了心力衰竭患者的现况调查。方法 在上海市 16家二级和三级医院的门诊根据预先编制的调查表询问患者 ,并进行体格检查得到所需资料。结果 男性患者略占多数 (5 7 6 % ) ,年龄 (70 3± 10 1)岁 (均数±标准差 )。最常见的病因是冠心病(6 5 8% )。纽约心脏学会 (NYHA)分级III级占 4 7 0 % ,IV级占 8 5 %。 1年内做过超声心动图的患者平均左室射血分数为 0 4 5。ACE I类药物和 β 受体阻滞剂的使用率分别为 6 1 0 %和 2 7 2 %。适合使用ACE I和 β 受体阻滞剂的患者中分别有 2 4 4 %和 70 0 %未用。硝酸酯类、地高辛和利尿剂仍为普遍使用的药物 ,其使用率分别为 77 5 %、5 9 5 %和 5 0 3%。结论 目前ACE I类药物和 β

Objective To obtain the information of baseline characteristics and ongoing therapies of patients with heart failure in Shanghai Methods A cross sectional study for outpatients with chronic heart failure(CHF) was held in 16 medical centers in Shanghai Data were collected by qualified interviewers and recorded on pre defined questionnaires Results 57 6% of the patients were male The most common cause for heart failure was coronary heart disease Median age was 72 years 47 0% of the patients were of New York Heart Association functional class Ⅲ and 8 5% were of class Ⅳ The average left ventricular ejection fraction available within one year was 0 45 by echo cardiogram Angiotensin conversion enzyme (ACE) inhibitors were given in 61 0% of the patients and beta blockers in 27 2% at the interview 24 4% of the patients sensitive to ACE inhibitors and 70 0% sensitive to beta blockers did not take the drugs Nitrates, digoxin and diuretics were in common use with a utilization rate of 77 5%, 59 5% and 50 3%, respectively Conclusions There is a great gap between optimal medical strategy and clinical practice in the management of CHF More patients will benefit from an optimized treatment including ACE inhibitors and beta blockers