鞍山市2015—2018年高血压住院患者药物流行病学特征分析

Antihypertensive regimen among primary hypertension inpatients,2015-2018:an analysis on medical records of three tertiary hospitals in Anshan city

目的分析辽宁省鞍山市2015—2018年高血压住院患者的药物流行病学特征,为进一步评估高血压患者的合理用药提供参考依据。方法于2019年6—12月采用分层随机抽样方法通过鞍山市某3家三级甲等医院信息系统随机抽取2015、2016、2017和2018年高血压住院患者的病历资料各300份进行高血压住院患者临床特征及降压药物使用情况的分析。结果鞍山市2015—2018年住院治疗的3600例高血压患者中,1级高血压患者525例(14.58%),2级高血压患者1032例(28.67%),3级高血压患者2043例(56.75%);伴发疾病包括左心室肥厚762例(21.17%)、颈动脉硬化301例(8.36%)、冠心病514例(14.28%)、心力衰竭324例(9.00%)、缺血性脑卒中447例(12.42%)、出血性脑卒中269例(7.47%)、慢性肾脏病227例(6.31%);使用降压药物单药治疗者1004例(27.89%),使用联合用药治疗者2596例(72.11%);单药治疗方案中,采用钙离子拮抗剂(CCB)治疗方案的构成比最高(32.37%),其次为采用血管紧张素转化酶抑制剂(ACEI)治疗方案(20.92%);联合用药治疗方案中,采用ACEI/血管紧张素Ⅱ受体拮抗剂(ARB)+CCB+利尿剂治疗方案的构成比最高(22.65%),其次为采用ACEI/ARB+β–受体阻滞剂+CCB治疗方案(22.61%)。结论鞍山市2015—2018年高血压住院患者以3级高血压患者居多,多伴发左心室肥厚、冠心病、缺血性脑卒中等疾病,单药治疗以CCB类药物为主,联合用药治疗以ACEI/ARB+CCB+利尿剂方案为主。

Objective To examine antihypertensive regimens among primary hypertension inpatients during 2015–2018 in Anshan city of Liaoning province for evaluating rational medication of hypertensive patients.Methods Using stratified random sampling through hospital information systems,we extracted medical records of 3 600 primary hypertension patients hospitalized at three tertiary first-class hospitals during 2015-2018(300 records/per year/per hospital) in Anshan city.The clinical characteristics and antihypertensive regimens of the inpatients were statistically analyzed.Results Of all the inpatients,525(14.58%),1 032(28.67%),and 2043(56.75%) were diagnosed with hypertension of stage Ⅰ,Ⅱ,and Ⅲ,respectively.The proportions of the inpatients having concomitant diseases were21.17% for left ventricular hypertrophy,8.36% for carotid atherosclerosis,14.28% for coronary heart disease,9.00% for heart failure,12.42% for ischemic stroke,7.47% for hemorrhagic stroke,and 6.31% for chronic kidney disease.Among all the inpatients during the hospitalizations,1 004(27.89%) had single antihypertensive medication and 2 596(72.11%) had combined antihypertensive medication.Among the monotherapy regimens,calciumion antagonists(CCB) was the most frequently used drug in 325(32.37%)of the inpatients,followed by angiotensin converting enzyme inhibitors(ACEI) in210(20.92%) of the inpatients.Of the inpatients with the combined regimens,588(22.65%) had the medication of ACEI/angiotensin receptor blocker(ARB) plus CCB plus diuretic and 587(22.61%) had the medication of ACEI/ARB plus β-receptor blocker plus CCB.The antihypertensive regimens differed significantly by hypertension stage among the inpatients(χ^(2) = 1 922.86,P < 0.001).Conclusion For the primary hypertensive patients hospitalized during 2015-2018 in Anshan city,more than a half had stage Ⅲ hypertension and left ventricular hypertrophy,coronary artery disease,and ischemic stroke were major concomitant diseases;CCB was a main monotherapy and ACEI/ARB plus CCB plus diuretic was a main combined antihypertensive regimen in the treatment of the inpatients during hospitalization.