摘要
目的:分析近30年慢性心力衰竭住院患者利尿剂应用状况及变化。方法:整理天津武警医学院附属医院心脏科1980-01-2008-01住院的慢性心力衰竭患者病例,按照病因、年龄、心功能(NYHA)分级、年代等分组进行回顾性分析。结果:入选2458例,共1660例患者住院期间使用利尿剂(67.5%),其中静脉袢利尿剂应用最多(64.0%),特别是在心功能NYHAⅣ级、风湿性心脏病及扩张型心肌病患者中。各年代利尿剂的使用率均较高(61.2%vs71.0%vs66.5%,P<0.05),其中袢利尿剂及螺內酯的使用率呈逐年代增加趋势,且利尿剂与血管紧张素转化酶抑制剂(ACEI)、β-受体阻滞剂的联合应用亦有增加趋势。患者住院病死率呈逐年代降低趋势(9.5%vs8.9%vs5.3%,P<0.01),住院天数亦明显缩短。结论:利尿剂在慢性心力衰竭治疗中占有重要地位,随年代变迁,袢利尿剂及螺內酯的使用率呈增加趋势蚣劣階CEI、β-受体阻滞剂的联合应用亦呈增加趋势,但与指南差距仍较大。
Objective：To investigate the characteristics of the diuretic application in patients with chronic heart failure during the recent 30 years.Method：All data were taken from the hospitalized cases with chronic heart failure from Jan 1980 to Jan 2008.They were divided into different groups according to the age,gender,cardiac function classification,etiology and decades,et al,to make retrospective case analysis.Result：A total of 2 458 cases was enrolled,among which there were 1660 patients used diuretics （67.5%）.Loop diuretics were the most commonly prescribed diuretics （64.0%）,especially in patients with Heart Failure of New York Heart Association class IV,rheumatic heart disease and dilated cardiomyopathy.The usage frequencies were all high in different decades （61.2% vs 71.0% vs 66.5%）,among which loop diuretics and spironolactone application increased essentially.The combination drug application,including ACEI,β-blocker with diuretic also increased by decades.The in-hospital mortality rates of CHF decreased significantly after year 2000 （9.5% vs 8.9% vs 5.3%,P0.01） and the admission time were shorter with decades.Conclusion：Diuretics still dominated the major pharmaceutical application in clinical heart failure therapy.Loop diuretic and spironolactone application and the combination drug application,including ACEI,β-blocker with diuretic also increased by decades,but there is still a distance between clinical practice and guideline of CHF treatment.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2010年第6期439-442,共4页
Journal of Clinical Cardiology
