急诊主动脉夹层患者抗高血压用药分析

Analysis of antihypertensive drugs in emergency outpatients with aortic dissection

目的了解急诊主动脉夹层患者抗高血压用药现状,为临床合理用药提供参考。方法利用医院管理信息系统(hospital information system,HIS)抽取广东省人民医院2016年1月至12月诊断为主动脉夹层的急诊电子处方,统计患者的年龄、性别、诊断、治疗用药等,根据国内、外文献及指南对用药合理性进行分析。结果共纳入急诊患者2 403例次,男性为主,占85.85%;45～60岁年龄段患者最多,占46.73%。1 703例次(70.87%)使用了抗高血压药物,其中使用β受体阻断药(βreceptor blocker,βRB)和钙通道阻滞剂(calciumchannel blockers,CCB)的患者最多,分别占60.07%和59.54%;降压方案以单用和二联为主,分别占45.10%和38.11%,其中使用CCB+βRB、CCB和βRB降压的患者最多,分别占18.85%、17.56%和13.92%,使用频次最高的降压药为地尔硫艹卓注射液、艾司洛尔注射液和硝普钠针注射液。是否并发高血压对降压方案选择无明显影响。结论该院急诊主动脉夹层患者以中青年男性为主,多选择βRB和CCB,以单用和二联为主,用药基本合理。

Objectives To understand the application status of antihypertensive drugs in emergency patients with aortic dissection(AD),and to provide the reference for the clinic.Methods Emergency prescriptions with diagnosis of aortic dissection were randomly collected from hospital information system(HIS)during the whole 2016 year in Guangdong Provincial People′s Hospital,and the data of patient′s gender,age,diagnosis and medications,and the rationality of medications were evaluated by the domestic and overseas′guidelines.Resluts Of the 2 403 patients included,male patients constituted 85.85%,and patients aged from 45 to 60 had the most composition ratio of 46.73%;1 703 patients(70.87%)used antihypertensive drugs,in which most patients were prescribedβreceptor blocker(βRB,60.07%)and calcium channel blocker(CCB,59.54%);only one antihypertensive drug used or combined two drugs constituted 45.10%and 38.11%,respectively,in which the scheme of CCB plusβRB,CCB andβRB were most prescribed(18.85%,17.56%,13.92%respectively),while the single antihypertensive drug of diltiazem for injection,esmolol for injection and sodium nitroprusside for injection were most prescribed.Meanwhile,the scheme of antihypertension was not significant difference between AD patients with hypertension whether or not.Conclusions AD patients in this clinic are mainly consisted of younger and middle aged males,βRB and CCB are most prescribed while one or two antihypertensive drugs are most common.In short,medications for AD are basically reasonable.