基于数据挖掘精准分析冠状动脉粥样硬化性心脏病患者临床降脂药物的应用

Accurate Analysis of Clinical Lipid-lowering drugs for CHD Patients based on Data Mining

目的探讨冠状动脉粥样硬化性心脏病(CHD)患者口服降脂药物的应用情况,分析使用特点,为合理应用降脂药物和循证医学提供参考。方法收集中南大学湘雅二医院和湖南省中医药大学第一附属医院心内科和老年病学科的住院CHD患者电子病历资料2400份,采用SPSS软件,通过数据挖掘,精准分析CHD患者的临床用药情况。结果大部分CHD不同危险分层患者住院期间接受他汀类药物和他汀类联合降脂药物治疗,23.25%的CHD患者住院期间接受他汀类高强度药物治疗,出院时患者低密度脂蛋白胆固醇(LDL-C)控制水平基本不理想。口服降脂药物使用次数最多为他汀类,而用药频度(DDDs)最高为瑞舒伐他汀钙片,在药物利用指数(DUI)方面,使用的降脂药都在1以下,基本合理。结论CHD患者仍未得到充分治疗,并且接受他汀类药物治疗的患者出院时尚未达到治疗的理想目标。LDL-C的控制效果明显与CHD患者降脂药物方案、用药强度和用药依从性相关。

Objective To explore the situation of oral use of lipid-lowering drugs in patients with coronary atherosclerotic heart disease(CHD)and analyze its characteristics,so as to provide a reference for rational use of lipid-lowering drugs and evidence-based medicine.Methods 2400 electronic medical records of hospitalized CHD patients from Xiangya Second Hospital of Central South University and the Department of Cardiology and Geriatry of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine were collected.Using SPSS software and data mining,we accurately analyzed the clinical medication status of CHD patients.Results During hospitalization,most patients with different risk stratification of CHD received statin and statin combined lipid-lowering drugs.23.25%of CHD patients received statin high-intensity drug treatment during hospitalization,and the ldL-C control level of the patients was not satisfactory at the time of discharge.The most frequently used oral lipid-lowering drugs are statins,while the highest DDDs are Rosuvastatin calcium tablets.In terms of DUI,the number of lipid-lowering drugs used is below 1,which is basically reasonable.Conclusion CHD patients in this area are still not adequately treated,and patients receiving statins have not reached the ideal treatment target when discharged from hospital.The therapeutic control of LDL-C was significantly correlated with lipid lowering medication regimen,medication intensity,and medication compliance in patients with coronary atherosclerotic heart disease,indicating that there is still considerable potential for LDL-C control throughout the region.