摘要
目的对天津和新疆喀什两个地区的慢性心力衰竭（心衰）住院病例进行回顾性调查，分析不同地区心衰干预药物的应用情况，以及实际应用与指南的差距，旨在为临床更好地治疗心力衰竭提供借鉴。方法对2005年6月至2006年6月天津医科大学第二医院心脏科及喀什第二人民医院心内科出院第一诊断为慢性心力衰竭，且心功能NYHA分级为Ⅱ～Ⅳ级的病例采用回顾性方法，分析两地区心衰干预药物的应用情况。结果入选749例，天津组491例，喀什组258例。天津组平均年龄（70．39±10．84）岁，高于喀什组平均年龄（62．91±12．54）岁（t=8．488，P〈0．01）。天津组≥65岁的构成比（75．6％）高于喀什组（51．2％）（χ^2=45．642，P〈0．01）。天津组男性264例（53．8％），喀什组男性134例（51．9%），2组间性别分布差异无统计学意义（P〉0．05）。天津组患者的前3位病因为冠心痛（84．9％）、风心病（5．9％）和扩心病（3．3％），而喀什组则为冠心病（63．2％）、肺心病（19．8％）和扩心病（6．6％）。入院时心功能NYHAⅡ、Ⅲ、Ⅳ级所占比率：天津组分别为29．7％、39．1％和31．2％，喀什组分别为15．5％、39．5％和45．0％，2组分布差异有统计学意义（χ^2=22．770，P〈0．01）。天津组患者硝酸酯类和β-受体阻滞剂的使用率高于喀什组（P均〈0．01），而利尿剂、洋地黄制剂和醛固酮拮抗剂的应用则以喀什组较多（P均〈0．01），两组患者ACEI的使用率差别无统计学意义。但是天津组患者的ACEI种类多，多数剂量达到“指南”要求的靶剂量，而喀什组患者用药较单一，且剂量偏小，与“指南”要求差距较大。天津组患者β-受体阻滞剂在男性和〈65岁组应用较多（P均〈0．05）。喀什组患者利尿剂和醛固酮拮抗剂在〈65岁组应用较多；硝酸酯类、ACEI、β-受体阻�
Objective To compare drug therapy in patients suffering from chronic heart failure between Tianjin and Kashi region of Xinjiang autonomous region and to analyse their disparities in drug uses by guideline between the two regions. Methods All data were retrospectively taken from the hospitalized chronic heart failure cases from June 2005 to June 2006 in the 2nd Hospital of Tianjin Medical University and the 2nd People＇s Hospital of Kashi in Xinjiang respectively. The heart functions level NYHA Ⅱ -Ⅳ were recorded for analysis of drug use in the two regions. Results 749 cases were enrolled ,491 from Tinajin and 258 from Kashi of Xinjiang. The average age of group Tianjin [ （70.39 ± 10.84 ） yrs ] was older than that [ （62.91 ± 12.54 ） yrs ] of group Kashi （ t = 8. 488, P 〈 0.01 ）. The distribution of ≥65 cases in the group Tianjin（75.6% ） was higher than that of group Kashi（51.2% ） （χ^2 =45. 642,P 〈0.01 ）. The male cases in group Tianjin were 264（53.8% ） and that were 134（51.9% ）in group Kashi with no significant differences in sex distribution between the two groups （P 〉 0.05 ）. The first three etiological diseases were coronary heart disease （ 84. 9% ）, rheumatic heart disease （5.9%） and dilated cardiomyopathy （3.3%） in group Tianjin , and that were coronary heart disease （ 63.2% ）, pulmonary heart disease （ 19.8% ） and dilated cardiomyopathy （6.6%） in group Kashi respectively. The proportions of level NYHA Ⅱ , Ⅲ, Ⅳ on admission were 29.7% ,39.1% and 31.2% in group Tianjin respectively,and that were 15.5% ,39.5% and 45.0% in group Kashi respectively, with significant difference in heart function levels between the two groups （χ^2 = 22. 770, P 〈 0.01 ）. Theusages of nitrides and β-blockers in group Tianjin were more than that in group Kashi（ both P 〈0.01 ）. The usages of diuretics, digitalis was more in group Kashi （ all P 〈 0.01 ）. There was no difference in ACEI usages between the two groups. The dosages of drugs
出处
《中国综合临床》
2009年第3期263-266,共4页
Clinical Medicine of China
基金
天津市科委重点资助项目（033111311）
