252例老年心房纤颤合并心力衰竭的药物治疗与相关指南的差距  

Insufficient medications for atrial fibrillation and cardiac dysfunction in elderly hospitalized patients by comparison with related guidelines

作　　者：徐军[1] 缪东培[1] 包知达[1] 肖继明[1] 吕磊[1] 殷宇刚[1] 张凯[1] 

机构地区：[1]南京军区南京总医院心脏内科,江苏南京210002

出　　处：《医学研究生学报》2009年第1期51-53,共3页Journal of Medical Postgraduates

摘　　要：目的:了解在住院的老年心房纤颤(简称房颤)合并心力衰竭的患者中β受体阻滞剂(Beta blocker)、血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)以及抗凝药物的应用现状,探讨与相关指南的差距。方法:通过回顾性分析,对在2004年2月至2007年12月期间住院的252例老年心房纤颤合并心力衰竭的患者进行调查,记录和统计有关的资料。结果:入院时Beta-blocker、ACEI或ARB和抗凝治疗分别达到85.0%,78.2%,96.4%;但出院时减少至50.4%,54.8%,77.0%,仅8.7%的患者服华法林钠。各种药物的剂量均低于指南的要求,停药或减量的主要原因是药物相关的副作用和对治疗的不依从性。结论:在住院的老年房颤合并心力衰竭患者中,Beta-blocker、ACEI或ARB以及抗凝药物的应用不足,主要与药物的副作用有关。Objective ： To gain an insight into the administration of Beta blockers, angiotensin converting enzyme inhibitors （ACEI） or angiotensin receptor blockers （ARB） and anticoagulation agents in elderly patients hospitalized for atrial fibrillation and cardiac dysfunction by comparison with the related guidelines. Methods： We retrospectively studied 252 elderly patients hospitalized for atrial fibrillation and cardiac dysfunction from February, 2004 to December, 2007, their relevant data collected and statistically analyzed. Results ： In the beginning of hospitalization, Beta blockers, ACEI or ARB and anticoagulants were administered to 85.0, 78.2 and 96.4% of the patients, respectively, which dropped to 50.4, 54.8 and 77.0% at discharge, while warfarin was given to only 8.7% of them. The oral doses of the three drugs were all bellow those recommended by the related guidelines. Drug suspension and dose reduction were attributed to adverse drug effects and patients＇poor compliance. Conclusion： Beta blockers, ACEI or ARB and anticoagulants are insufficiently administered in the medication for atrial fibrillation and cardiac dysfunction in elderly hospitalized patients, which is mainly due to the adverse effects of the drugs and poor compliance of the patients.

关 键 词：房颤 心力衰竭 老年 

分 类 号：R541.61[医药卫生—心血管疾病]