慢性肾病与非慢性肾病老年高血压患者血压控制状况及抗高血压药治疗方案评估  

Evaluation of Blood Pressure Control and the Application of Antihypertensive Drugs in Elderly Hypertensive Patients with and without Chronic Kidney Diseases

作　　者：卞元清[1] 罗燕梅[1] 张国龙[1] 卞民亮[1] 张郁青[1] 

机构地区：[1]南京医科大学附属江宁医院药学部,南京211100

出　　处：《中国药房》2013年第34期3221-3224,共4页China Pharmacy

摘　　要：目的:调查慢性肾病[CKD(+)]与非慢性肾病[CKD(-)]老年高血压住院患者的血压控制状况及抗高血压药治疗方案,为临床用药提供参考。方法:回顾性分析2012年该院年龄≥65岁的高血压住院患者病历共814例,平均年龄(73.2±6.5)岁,根据出院诊断分为CKD(-)组(n=540)与CKD(+)组(n=274)。出院血压分别以目标血压<140/90 mm Hg及<130/80 mm Hg进行分析,结合抗高血压药治疗方案,评估两组老年高血压患者抗高血压药的选择与应用。结果:CKD(-)组目标血压<140/90 mm Hg者占79.8%,CKD(+)组占56.9%;CKD(-)组目标血压<130/80 mm Hg者占28.7%,而CKD(+)组仅占18.6%。两组患者中,单药使用率CKD(-)组为43.0%,CKD(+)组为36.1%;2种以上药物联用率CKD(+)组为63.9%,CKD(-)组为57.0%;3种以上药物联用率CKD(+)组为24.5%,CKD(-)组为14.8%。血管紧张素受体抑制剂和钙通道拮抗药为主导用药。α受体拮抗药在CKD(+)组中使用频数为32例(11.7%),远高于CKD(-)组9例(1.7%)。CKD(+)组较CKD(-)组使用了更多种类抗高血压药([2.0±1.0)vs.(1.8±0.8),P<0.01]。结论:相对于CKD(-)患者,CKD(+)的老年高血压患者尽管使用更多种类的抗高血压药,但达到目标血压的比例更低。OBJECTIVE：To investigate blood pressure control and treatment plan of antihypertensive drugs in the elderly hypertensive inpatients [CKD（-）means non-chronic renal disease and CKD（＋）means chronic renal disease],and to provide reference for rational use of drugs.METHODS：814 hypertensive inpatients aged 65 year-old above with（73.2 ± 6.5）year-old in average were analyzed retrospectively in our hospital in 2012.They were divided into CKD（-）group（n=540）and CKD（＋）group（n= 274）according to clinical diagnosis.The target blood pressure under 140/90 mm Hg and under 130/80 mm Hg were analyzed,and the selection and application of antihypertensive drugs were analyzed on the basis of treatment plan of antihypertensive drug.RESULTS：79.8% of patients in CKD（-）group and 56.9% in CKD（＋）group could reach the target blood pressure under 140/90 mm Hg;28.7% in CKD（-）group and only 18.6% in CKD（＋）group could reach a level under 130/80 mm Hg.The rate of single antihypertensive drug was 43.0% in CKD（-）group and 36.1% in CKD（＋）group.The rate of combination of two or more kinds of drugs was 63.9% in CKD（＋）group and 57.0% in CKD（-）group.The rate of combination of three or more kinds of drugs was 24.5% in CKD（＋）group and 14.8% in CKD（-）group.The dominant drugs were ARB and CCB.The frequency of α receptor antagonist in CKD（＋）group（32 cases,11.7%）was significantly higher than in CKD（-）group（9 cases,1.7%）.More kinds of antihypertensive drugs were used in CKD（＋）group,compared with CKD（-）group（[2.0±1.0）vs.（1.8±0.8）,P 0.01].CONCLUSIONS：Elderly hypertensive patients with CKD need more kinds of antihypertensive drugs compared to CKD（-） group,nevertheless,more patients fail to achieve the target blood pressure.

关 键 词：老年高血压 血压 抗高血压药 慢性肾病 

分 类 号：R969.3[医药卫生—药理学]