某院老年慢性心力衰竭住院患者用药现状分析

Current Status on Medication of Elderly Inpatients with Chronic Heart Failure in a Hospital

目的分析老年慢性心力衰竭(CHF)住院患者用药现状。方法选取医院2018年6月至2023年6月收治的老年(≥65岁)CHF患者417例,统计患者入院时和出院时的用药种数,分析多药(≥5种)治疗情况,并将全部用药分为CHF相关药物、非CHF心血管系统药物和非心血管系统药物,计算三者的占比。统计患者住院期间用药种类,以及入院时和出院时常用药物类型及具体种类。结果入院时患者多药治疗率为50.84%,所用药物中CHF相关药物、非CHF心血管系统药物和非心血管系统药物分别占28.56%,21.42%,50.02%,出院时分别为54.92%及32.73%,19.45%,47.82%;患者入院时和出院时用药种类均以5~9种最多(26.62%,31.65%)。患者住院期间较常使用的3类药物为β受体拮抗剂、血管紧张素转化酶抑制剂(ACEI)、抗血小板聚集药(阿司匹林)。入院时和出院时,CHF相关药物使用率较高的均为β受体拮抗剂、袢利尿剂,非CHF心血管系统药物均为抗血小板聚集药(阿司匹林)、他汀类,非心血管系统药物均为质子泵抑制剂、电解质补充剂、复合维生素;且患者出院时前述药物使用率均较入院时有一定升高。结论该院老年CHF患者入院时和出院时多药治疗率均较高,且其中非心血管系统药物占比较大,临床应高度关注相关用药的合理性与安全性,且有必要制订相关策略加以监督。

Objective To analyze the current status on the medication of elderly inpatients with chronic heart failure(CHF).Methods A total of 417 elderly patients(≥65 years)with CHF admitted to the hospital from June 2018 to June 2023 were selected.The variety of drugs used by the patients at admission and discharge was counted,and the polypharmacy(≥five kinds of drugs)therapy was analyzed;all drugs used were divided into CHF-related drugs,non-CHF cardiovascular drugs and non-cardiovascular drugs,and the proportions of the three were calculated.The variety of drugs used by patients during hospitalization,the commonly-used drug category and specific variety at admission and discharge were counted.Results The polypharmacy therapy rate of patients on admission was 50.84%,with CHF-related drugs,non-CHF cardiovascular drugs and non-cardiovascular drugs accounting for 28.56%,21.42%,50.02%,respectively;the polypharmacy therapy rate of patients at discharge was 54.92%,with the above three drugs accounting for 32.73%,19.45%,47.82%,respectively.Five to nine varieties of drugs were most commonly used by patients at admission and discharge(26.62%,31.65%).The three categories of drugs commonly used by patients during hospitalization wereβ-receptor blockers,angiotensin-converting enzyme inhibitors(ACEIs)and platelet aggregation inhibitors(aspirin).At admission and discharge,β-receptor blockers and loop diuretics were the most common CHF-related drugs,platelet aggregation inhibitors(aspirin)and statins were the most common non-CHF cardiovascular drugs,proton pump inhibitors,electrolyte supplements and multivitamins were the most common non-cardiovascular drugs;moreover,the usage rates of the above drugs were higher at discharge than those on admission.Conclusion The polypharmacy therapy rate of elderly patients with CHF in this hospital is high at admission and discharge,with non-cardiovascular drugs accounting for a large proportion.We should pay close attention to the rationality and safety of relevant medications in clinical practice,and it is necessary to formulate relevant strategies for supervision.