住院高血压儿童用药现状:一项多中心研究

Application of antihypertensive medication among hospitalized children with hypertension:a multicenter study in China

目的 了解我国住院高血压患儿近10年的降压药使用情况。方法 研究对象来自福棠儿童医学发展研究中心理事成员9家三甲级别儿童医院,对2010年1月至2020年12月期间出院诊断中包含“高血压”的18岁以下首次住院患儿病案资料进行分析。最终纳入5 384例进高血压儿童,采用卡方检验/Fisher确切概率检验分析不同高血压分类儿童的用药种类、超说明书用药及联合用药情况。结果 5 384例住院高血压患儿中,共2 930例(54.4%)患儿接受了降压药治疗。用药患儿中,总体以钙通道阻滞药(CCB)和血管紧张素转换酶抑制药(ACEI)为最常用的降压药种类,二者的联合用药为最常见的用药方案。但不同高血压类型、程度、亚型的患儿,用药种类与联合用药情况差异较大。此外,1 325例(45.2%)患儿接受了超说明书用药。结论 我国住院高血压患儿以CCB和ACEI为主要应用的降压药种类,且存在较为普遍的超说明书用药情况。

Objective To investigate the use of antihypertensive drugs in hospitalized children with hypertension in China in the past 10 years.Methods The data were collected from 9 tertiary children's hospitals of Futang Research Center of Pediatric Development.A total of 5384 children who were diagnosed with hypertension and hospitalized for the first time between January 2010 and December 2020 were included for the analyses.The drug types,off-label use of drugs and drug combination among children with different subtypes of hypertension were analyzed using Chi-square test/Fisher exact probability test.Results Among the 5384 hospitalized hypertensive children,2930(54.4%)were received antihypertensive drugs.Calcium channel blockers(CCB)and angiotensin-convertingenzyme inhibitor(ACEI)were the most commonly used drug types,and their combination was the most common drug regimen for the children who received with antihypertensives,However,the drug types and combinations of drugs varied greatly among children with different causes,degrees and subtypes of hypertension.In addition,1325(45.2%)children received off-label medications.Conclusion The most frequent antihypertensive drugs are CCB and ACEI among hospitalized hypertensive children in China,and the use of off-label antihypertensive medications is prevailed.