心血管内科住院患者抗高血压药物用药合理性调查

Investigation on the Rationality of Antihypertensive Drugs in Hospitalized Patients of Cardiovascular Medicine

目的分析心血管内科住院患者抗高血压药物的用药合理性。方法收集我院2019年12月~2020年12月428例高血压住院患者的临床资料,分析其抗高血压药物的用药合理性。结果抗高血压药物中,钙通道阻滞剂(CCB)使用频率最高,其次分别为β受体阻滞剂(β-RB)、利尿剂、血管紧张素转换酶抑制剂(ACEI)、血管紧张素Ⅱ受体阻滞剂(ARB)以及复方制剂;使用频率最高的抗高血压药物为硝苯地平控释片,其次分别为酒石酸美托洛尔缓释片、马来酸依那普利片、氢氯噻嗪片以及缬沙坦胶囊。DDDs值最高的药物为硝苯地平控释片,其次分别为酒石酸美托洛尔缓释片、马来酸依那普利片、氢氯噻嗪片以及缬沙坦胶囊。其中硝苯地平控释片DUI为0.98,酒石酸美托洛尔缓释片DUI为0.93,马来酸依那普利片DUI为1.02,氢氯噻嗪片DUI为0.97,缬沙坦胶囊DUI为0.90。单一用药58例,二联用药181例,三联用药143例,四联用药40例,五联用药4例,六联用药2例。CCB联合β-RB联用方法最多(15.65%);其次分别为CCB联合ACEI(12.62%)、CCB联合β-RB以及利尿剂(10.98%)、利尿剂联合ACEI(7.01%)、ACEI联合β-RB以及利尿剂(6.78%)。结论我院抗高血压药物的应用整体较为科学,但仍存在一定的不合理现象,如药物选择不当、重复用药、药物联用不当、用药方法不当等。临床应根据高血压患者的疾病情况以及药物特点,保证用药的合理性,遵循个性化治疗原则,从而达到理想的疗效,改善患者预后。

Objective To analyze the rationality of antihypertensive drugs for inpatients in the Department of Cardiology.Methods The clinical data of 428 inpatients with hypertension in our hospital from December 2019 to December 2020 were collected,and the rationality of their antihypertensive drugs was analyzed.Results Among the antihypertensive drugs,calcium channel blockers(CCB)were used most frequently.Next wereβ-receptor blockers(β-RB),diuretics,angiotensin-converting enzyme inhibitors(ACEI),angiotensin II receptor blockers(ARB)and compound preparations;The most frequently used antihypertensive drugs were nifedipine controlled-release tablets,followed by metoprolol tartrate sustained-release tablets,enalapril maleate tablets,hydrochlorothiazide tablets,and valsartan capsules.The drug with the highest DDDs value was nifedipine controlled-release tablets,followed by metoprolol tartrate sustained-release tablets,enalapril maleate tablets,hydrochlorothiazide tablets and valsartan capsules.Among them,the DUI of nifedipine controlled-release tablets was 0.98,the DUI of metoprolol tartrate sustained-release tablets was 0.93,the DUI of enalapril maleate tablets was 1.02,the DUI of hydrochlorothiazide tablets was 0.97,and the DUI of valsartan capsules was 0.90.There were 58 cases of single medication,181 cases of double combination,143 cases of triple combination,40 cases of quadruple combination,4 cases of five combination,and 2 cases of six combination.CCB combined withβ-RB had the most combined methods(15.65%);followed by CCB combined with ACEI(12.62%),CCB combined withβ-RB and diuretics(10.98%),diuretics combined with ACEI(7.01%),ACEI combined withβ-RB and diuretics(6.78%).Conclusion The overall application of antihypertensive drugs in our hospital is relatively scientific,but there are still certain unreasonable phenomena,such as improper drug selection,repeated medication,improper combination of drugs,improper medication methods,etc.The clinic should ensure the rationality of the medication according to the disease situation and the characteristics of the drugs in patients with hypertension,and follow the principles of individualized treatment,so as to achieve the desired curative effect and improve the prognosis of the patients.