β受体阻滞剂治疗依从性对心力衰竭患者终点事件的影响

Impact of compliance toβ-blocker therapy on endpoint events of heart failure

目的探讨β受体阻滞剂治疗依从性对合肥市及周边地区心力衰竭(HF)患者终点事件的影响。方法收集2015年7月1日至2018年7月1日于安徽医科大学第三附属医院就诊的HF患者,连续入组36个月,纳入首次诊断为HF、出院处方开具β受体阻滞剂、合肥市城镇职工医保且门诊HF慢性病定点取药的患者132例。出院后连续3个月门诊开取β受体阻滞剂的患者为治疗依从组(A组,n=51),其余患者为未依从治疗组(N组,n=81)。中位随访时间25个月(IQR:18~33个月),比较两组HF再住院及心源性死亡的发生情况。结果β受体阻滞剂在HF患者中的使用率为38.6%(51/132)。A组HF总再住院率较N组显著降低[15.7%(8/51)比33.3%(27/81),P<0.05]。A组心源性死亡及急性HF发作的发生率较N组均显著降低[5.9%(3/51)比18.5%(15/81),7.8%(4/51)比14.8%(12/81),均P<0.05]。结论β受体阻滞剂在合肥市及周边地区临床实际使用率较低,β受体阻滞剂依从治疗能改善HF患者的临床预后。

Objective To investigate the impact of compliance toβ-blocker therapy on endpoint event of heart failure(HF)among patients in Hefei and its surrounding regions.Methods HF patients treated in Third Affiliated Hospital of Anhui Medical University were consecutively enrolled during 36 months between July 1,2015 and July 1,2018.Finally included in this study were a total of 132 patients who had been initially diagnosed with HF,prescribedβ-blockers at discharge,covered by Hefei urban medical insurance service for employees,and scheduled for drug refill at designated chronic disease HF clinics.Patients prescribedβ-blockers at these clinics in three consecutive months after discharge were assigned to the treatment compliance group(group A,n=51),and the remaining,to the treatment non-compliance group(group N,n=81).The median follow-up time was 25 months(IQR:18 to 33 months).The incidence of HF-related rehospitalization and cardiac death was compared between the two groups.Results The use ofβ-blockers was noted in 38.6%(51/132)of the HF patients.The total rate of HF-related rehospitalization in group A was significantly lower than that in group N[15.7%(8/51)vs 33.3%(27/81),P<0.05].The incidence of cardiac death and acute HF attack in group A was significantly lower than those in group N[5.9%(3/51)vs 18.5%(15/81),7.8%(4/51)vs 14.8%(12/81),both P<0.05].Conclusion The actual use ofβ-blockers in Hefei and its surrounding regions is fairly low.Compliance toβ-blocker therapy can improve the clinical prognosis of HF patients.