我院2018年急性冠脉综合征患者他汀类药物应用情况分析

Analysis of the application of statins in patients with acute coronary syndrome in our hospital in 2018

目的了解本院心内科病区急性冠状动脉(冠脉)综合征(ACS)患者他汀类药物的用药情况,分析临床用药特点,促进临床合理用药。方法采用回顾性调查方法 ,统计本院心内科2018年1~12月的住院ACS患者应用他汀类药物的病历,共130份,调查患者的一般情况、在院期间使用他汀类药物的情况、血清肌酐(Scr)、血脂、转氨酶及肌酸激酶(CK)水平,合并用药情况等。结果本院ACS患者入院后基本上均予以他汀类药物。患者年龄为28~93岁。130例患者中ACS疾病类型包括:不稳定型心绞痛(UA)54例(41.54%)、非ST段抬高型心肌梗死(NSTEMI)27例(20.77%)、ST段抬高型心肌梗死(STEMI)49例(37.69%)。130例患者使用他汀类药物情况为:使用阿托伐他汀115例(88.46%)、瑞舒伐他汀11例(8.46%)、辛伐他汀3例(2.31%)、氟伐他汀1例(0.77%),其中阿托伐他汀的使用剂量为20~40 mg,其余他汀类药物均为常规剂量。使用阿托伐他汀、瑞舒伐他汀、辛伐他汀、氟伐他汀患者的人均合并用药品种数分别为8.00、7.91、6.67、7.00种。130例患者入院初血Scr为(8.10~512.03)μmol/L,总胆固醇(TC)为(2.65~9.79)mmol/L、甘油三酯(TG)为(0.42~4.87)mmol/L、高密度脂蛋白胆固醇(HDL-C)为(0.69~2.27) mmol/L、低密度脂蛋白胆固醇(LDL-C)为(0.88~6.67)mmol/L,丙氨酸氨基转移酶(ALT)(5.60~590.00)U/L、天门冬氨酸氨基转移酶(AST)为(9.40~1142.00)U/L、CK为(25.00~8145.00)U/L。结论本院心内科ACS患者均使用了他汀类药物,绝大部分患者均为常规使用他汀类药物,整体上为合理使用他汀类药物,而个别患者在肝功能异常的情况下应慎用他汀类药物。临床药师应积极参与临床治疗,为心内科病区提供优质药学服务。

Objective To understand the use of statins in patients with acute coronary syndrome(ACS) in the cardiological department of our hospital, analyze the characteristics of clinical medication, and promote rational clinical medication. Methods A retrospective survey method was used to calculate the medical records of 130 ACS patients treated by statins in Department of Cardiology from January to December 2018. The general situation of the patients, the use of statins in hospital, the level of serum creatinine(Scr), blood lipid, transaminase and creatine kinase(CK), and concomitant medication were investigated. Results The ACS patients were treated with statins after admission, and the age of the patients was 28-93 years old. Among the 130 ACS patients, the types of acute coronary syndrome include 54 cases of unstable angina(UA)(41.54%), 27 cases of non-ST elevation myocardial infarction(NSTEMI)(20.77%), and 49 cases of ST elevation myocardial infarction(STEMI)(37.69%). Use of statins in 130 patients: 115 cases(88.46%) of atorvastatin, 11 cases of rosuvastatin(8.46%), 3 cases of simvastatin(2.31%), 1 case of fluvastatin(0.77%), of which the atorvastatin dosage was 20-40 mg, and the rest of the statins were regular doses. There were 8.00, 7.91, 6.67 and 7.00 varieties of combination drugs in patients with atorvastatin, rosuvastatin, simvastatin and fluvastatin. The initial Scr of 130 patients was(8.10-512.03) μmol/L, total cholesterol(TC) was(2.65-9.79) mmol/L, triglyceride(TG) was(0.42-4.87) mmol/L, high density lipoprotein cholesterol(HDL-C) was(0.69-2.27) mmol/L, low density lipoprotein cholesterol(LDL-C) was(0.88-6.67) mmol/L, alanine aminotransferase(ALT) was(5.60-590.00) U/L, aspartate aminotransferase(AST) was(9.40-1142.00) U/L, CK was(25.00-8145.00) U/L. Conclusion ACS patients in the department of cardiology of our hospital all use statins. Most of the patients are routinely using statins, and the overall use of statins is reasonable. Patients with abnormal liver function should use statins with caution. Clinical pharmacists should actively participate in clinical treatment and provide high-quality pharmacy services for cardiology departments.