中国二级以上医院门诊初次诊断为高血压患者用药调查  

Investigation of drug use in newly-diagnosed hypertensive outpatients in secondary and tertiary hospitals in China

作　　者：贾贡献[1] 余金明[1] 林凡礼[1] 刘力生[2] 霍勇[3] 王文 胡大一[5] 

机构地区：[1]复旦大学公共卫生学院公共卫生安全教育部重点实验室,上海200032 [2]北京高血压联盟研究所 [3]北京大学第一医院心内科 [4]中国医学科学院阜外医院高血压中心 [5]北京大学人民医院心脏中心

出　　处：《中华高血压杂志》2013年第9期843-847,共5页Chinese Journal of Hypertension

摘　　要：目的探讨中国二级以上医院门诊中,初次诊断为高血压患者的用药情况。方法 2011-03-05,在全国29个城市129家二级以上医院的心血管内科、普通内科、高血压科和老年科4个科室门诊进行横断面临床流行病学调查,每位医生连续登记诊治的5例高血压患者为研究对象,共收集824位医生诊治的高血压患者资料4120例,剔除3例逻辑错误,共得到4117例,记录其人口学特征、血压控制情况及用药信息。结果 4120例患者中,初次诊断为高血压的515例,治疗率为98.3%,其中1级高血压109例,治疗率为99.1%。最常用药物是血管紧张素受体拮抗剂(ARB)占71.5%,其次是钙拮抗剂占32.6%和β受体阻滞剂占18.1%,最后是血管紧张素转换酶抑制剂(ACEI)占9.3%和利尿剂占7.8%。单一用药占62.7%,最常用是ARB;二联用药占24.7%,最常用是钙拮抗剂+ARB;三联及以上用药占10.9%,最常用是β受体阻滞剂+钙拮抗剂+ARB。结论初次诊断为高血压的患者以单一和二联用药为主,用药方案与《中国高血压防治指南2010》要求有一定差距,存在药物不合理使用的现象。Objective To investigate the drug use of newly-diagnosed hypertensive outpatients in secondary and tertiary hospitals in China. Methods The cross-sectional study was conducted from March to May 2011 in 4 departments （cardiology, general internal medicine, hypertension and geriatrics） of 129 secondary and tertiary hospitals in 29 cities of China. Data of 4120 hypertensive outpatients were provided by doctors, each of which registered 5 consecutive outpatients undergoing treatments. Demographic characters, blood pressures and drug use data were collected from 4117 patients, excluding 3 cases of logical errors. Results Of the 4117 subjects, 515 were initially diagnosed hypertensive patients and 98.3% received treatment. Of the 515 newly diagnosed hypertensive, 109 were classified as mild hypertension and 99. 1% received treatment. The 4177 prescriptions with at least one antihypertensive prescription frequencies are： angiotensin receptor blockers （ ARB 71.5% ）, calcium channel blockers （ CCB, 32.6 % ）, beta-blockers （ 18.1 % ）, angiotensin-converting enzyme inhibitors （ ACEI 9.3 % ） and diuretics （ 7.8 % ）. Monotherapy accounted for 62.7% with ARB was most commonly applied, two-drug combination accounted for 24.7% with CCB/ARB was the most prescribed and three-drug combinations accounted for 10.9% with beta block- ers/CCB/ARB was most prescribed. Conclusions Compared with the requirement of ＂2010 Chinese guideline for the management of hypertension＂, there is a phenomenon of irrational drug use in newly-diagnosed hypertensive out-patients who mainly receive monotherapy or dual-combination treatment.

关 键 词：高血压 初始治疗 用药情况 

分 类 号：R544.1[医药卫生—心血管疾病]