摘要
目的 了解β受体阻滞剂（BB）在冠心病（CHD）治疗中的应用现状,结合相关指南及大型国内外研究结果评价其规范性.方法 选取2014年3月至2015年6月于山西医科大学第二医院心内科住院治疗并经冠脉造影确诊为CHD的663例患者,统计分析BB的使用情况及其相关影响因素.结果 本研究共纳入663例CHD患者,其中600例有BB适应证,实际使用率为83.0％,合并急性心肌梗死（AMI）患者使用率为86.4％,BB平均启用时间为1.38 d,起始日剂量≤25 mg,出院时平均日剂量未超过30 mg,且平均心率为（69.2±6.8）bpm;AMI和住院期间PCI患者与未合并上述状况者比较,BB使用率及平均日剂量明显增高,而合并2型糖尿病患者较未合并者平均日剂量降低,差异均有统计学意义（P＜0.05）.其余一般情况及合并症对BB的使用无显著影响（P＞0.05）.63例禁用或慎用BB的患者中,实际使用率为50％左右.患者使用的所有BB中,酒石酸美托洛尔片使用率最高.结论 我院CHD患者BB的使用率较国内大型临床试验研究结果偏高,接近国际使用水平,但日剂量明显不足,且出院时静息心率未达到目标值,与相关指南推荐存在差距,BB使用的规范性有待进一步提升.
Objective In this study,we aimed to investigate the application status of β receptor blockers （BB） in patients with coronary heart disease（CHD）,and evaluate the normativity of BB application through clinical guidelines and large series international and domestic reporting.Methods A total of 663 patients were enrolled in this study to statistical analysis the application status and related influencing factors of BB.All patients enrolled diagnosed as CHD and received treatment by coronary angiography in The second hospital of Shanxi medical university from March 2014 to June 2015.Results About 663 CHD patients were enrolled and 600 patients had indications for BB,the actual utilization rate is 83%.And near 86.4% of patients with acute myocardial infarction （AMI） apply the BB.The mean starting time of BB application was at 1.38 d after patient admission to hospital and the starting dose was 25 mg or less.When patients were leaving the hospital,the average daily dose was less than 30 mg,and the resting heart rate was（69.2±6.8）bpm.Compared with patients with AMI or once received PCI in hospital,the daily dose of patients without the above condition is significantly decrease,but the dose was lower in patients with diabetes mellitus type 2 than without,and all difference have statistically significant （P〈0.05）.The remaining general situation and complications have no significantly influence to BB＆#39;s application.For the other 63 CHD patients who should be forbid or prudent use of BB,the actual utilization rate is approximately 50%.Of all BB,ultimately,tartaric acid metoprolol was the most common medication.Conclusion The application rate of BB in patients with CHD in our hospital is higher than the domestic average and near international level.But the daily dose is deficient and resting heart rate is faster than the target suggested there was still existing gaps between guidelines and practice.So it is necessary to improve the normativity of BB.
出处
《中国心血管病研究》
CAS
2017年第5期463-466,共4页
Chinese Journal of Cardiovascular Research
关键词
冠状动脉疾病
Β受体阻滞剂
临床应用
Coronary heart disease
β receptor blockers
Clinical application
