摘要
目的 评价慢性收缩性心力衰竭“新的标准药物治疗”在干部病房老年患者中的实施状况。方法 以86例住院治疗的老年心力衰竭患者为研究对象,对标准药物治疗实施状况作出评价。结果 ①ACEI和β-受体阻滞剂的使用率分别为64.0％和34.9％,高于同期全国平均应用水平。ACEI在Ⅲ、Ⅳ级心功能的患者中使用率较高,β-受体阻滞剂在Ⅱ、Ⅲ级心功能的患者中使用率较高;②37.2％的患者因心脏传导阻滞、严重过缓性心律失常及低血压等原因而未使用或停用β-受体阻滞剂,13例患者因Ⅳ级心功能难以改善而未用或停用β-受体阻滞剂;③因医生的因素未使用或停用ACEI者26.7％,未使用或停用β-受体阻滞剂者12.8％。48.8％的患者在作出心力衰竭诊断后仍长期使用钙拮抗剂。结论 在干部病房老年心力衰竭患者中,新的标准药物治疗实施状况总体上较好,但老年患者合并症多,对实施标准药物治疗带来更多的难题。必须进一步在医师中普及心力衰竭治疗的新理论和新概念。
Objective To evaluate the performing of 'new standard pharmaceutical therapy' for chronic heart failure in elderly pa-tients at a cadre's ward. Methods 86 cases of elderly in patients with heart failure were analyzed to evaluate the performing of standard phar-maceutical therapy. Results ①The proportion of the users of ACEI and β-blocker were 64. 0% and 34. 9%, respectively, which were compar-atively higher than the mean levels of the overall nation. The rate of utilization of ACEI was relatively high in patients with NYHA class Ⅲ andⅣ, and for β-blocker, the rate of utilization was relatively high in patients with NYHA class Ⅱ and Ⅲ; ②37. 2% cases didn' t use or stoppedthe usage of β-blocker because of heard block, sevete brady-arrhythmia or hypotension, and 15. 1% cases didn' t use or stopped the usage of β-blocker because of the patients' cardiac function were graded as NYHA IV and unstable; ③Due to the physicians' reasons, 26. 7% cases didn't use or stopped the usage of ACEI, 12. 8% cases didn' t use or stopped the usage of β-blocker, and 48. 8% cases still used calcium channelblockers permanently after the diagnosis of heart failure. Cpnclusions The overall usage of the new standard pharmaceutical therapy was prettygood in elderly patients with heart failure at the cadre's ward, but there were more problems to use the standard therapy in elderly patients dueto their complications. It was important to diffuse the knowledge of the new concept of treatment strategy for heart failure in physicians.
出处
《解放军保健医学杂志》
2003年第4期220-222,共3页
Journal Of Health Care And Medicine in Chinese Pla
