391例急性冠状动脉综合征患者调节血脂药应用分析

Analysis of Application of Lipid-Regulating Drugs in 391 Patients with Acute Coronary Syndrome

目的:了解苏州大学附属第一医院(以下简称"我院")心血管内科急性冠状动脉综合征(acute coronary syndrome,ACS)患者调节血脂药的应用现状,为临床合理用药提供参考。方法:回顾性收集2017年1月至2018年6月入住我院心血管内科初诊为ACS患者的病历资料,参照药品说明书和相关诊疗指南,对其调节血脂药使用的合理性(包括适应证、禁忌证、药物选择、用法与用量及治疗方案调整等)进行统计分析和评价。结果:共纳入391例患者,其中3.07%(12例)的患者存在用药禁忌证;391例患者的初始治疗方案中均使用了调节血脂药,其中,他汀类药物的使用率为97.95%(383/391),2.81%(11/391)的患者使用了联合调脂方案;出院时有387例患者无调节血脂药使用禁忌证,其中,他汀类药物的使用率为91.73%(355/387),9.30%(36/387)的患者使用了联合调脂方案;住院期间,有23.79%(93/391)的患者进行了治疗方案的调整。结论:我院心血管内科ACS患者调节血脂药的使用与相关指南的推荐仍存在一定差距,表现在禁忌证、药物选择和方案调整等方面,应进一步规范。

OBJECTIVE: To investigate the application status of lipid-regulating drugs for patients with acute coronary syndrome(ACS) in the First Affiliated Hospital of Soochow University(hereinafter referred to as "our hospital"), so as to provide reference for the rational drug application in clinic. METHODS: Retrospective analysis was conducted on medical records of patients with ACS who were admitted into department of cardiovascular medicine in our hospital from Jan. 2017 to Jun. 2018. The rationality of application of lipid-regulating drugs(including indications, contraindications, drug selection, usage and dosage, and adjustment of treatment regimen) was statistically analyzed and evaluated by referring to drug instructions and relevant diagnosis and treatment guidelines. RESULTS: A total of 391 patients were included, of which 3.07%(12 cases) had drug contraindications. Lipid-regulating drugs were applied in the initial treatment regimen for 391 patients, among which the application rate of statins was 97.95%(383/391), and 2.81%(11/391) of the patients used the combined lipid-regulating regimen. At the time of discharge, 387 patients had no contraindications in the application of lipid-regulating drugs, among which, the application rate of statins was 91.73%(355/387), and 9.30%(36/387) of the patients used the combined lipid-regulating regimen. During hospitalization, 23.79%(93/391) of the patients underwent adjustment of the treatment regimen. CONCLUSIONS: There is still a certain gap between the application of lipid-regulating drugs for ACS patients in the department of cardiovascular medicine of our hospital and the recommendation of relevant guidelines, which should be further standardized in terms of contraindications, drug selection and treatment adjustment.