慢性收缩性心衰患者神经内分泌抑制剂用药规范化比较  

Comparison of standardized use of neuroendocrine inhibitors in patients with chronic systolic heart failure

作　　者：常辰毓 张晓燕[1] 张宏颖[2] 孙世龙 CHANG Chen-yu;ZHANG Xiao-yan;ZHANG Hong-ying;SUN Shi-long(Department of Pharmacy,Zhengzhou Second People′s Hospital,Zhengzhou 450006,China;Department of Cardiology,Zhengzhou Second People′s Hospital,Zhengzhou 450006,China;Department of Neurology,Zhengzhou Second People′s Hospital,Zhengzhou 450006,China)

机构地区：[1]郑州市第二人民医院药务科,河南郑州450006 [2]郑州市第二人民医院心内科,河南郑州450006 [3]郑州市第二人民医院神经内科,河南郑州450006

出　　处：《实用药物与临床》2021年第4期349-353,共5页Practical Pharmacy and Clinical Remedies

基　　金：郑州市常州四药临床药学科研基金(CZSYJJ16004)。

摘　　要：目的了解我院临床药师干预前后,慢性收缩性心力衰竭患者3类神经内分泌抑制剂的使用情况。方法收集临床药师干预前后的慢性收缩性心力衰竭患者,对患者临床特征、神经内分泌抑制剂应用情况进行统计分析,临床药师根据指南评价标准进行用药干预。结果干预后ACEI/ARB、ACEI、β-RI、MRA、ACEI/ARB+β-RI+MRA、ACEI+β-RI+MRA、ACEI/ARB+β-RI、ACEI+β-RI的出院带药率(83.10%、42.62%、88.57%、66.90%、46.30%、24.76%、26.90%、14.05%)均有显著性升高(P<0.05),干预后ARB的出院带药率由干预前的高于ACEI(34.34%vs.32.97%)降为低于ACEI(40.48%vs.42.62%)。ACEI/ARB、β-RI的剂量达标率分别由30.20%、40.91%升高为71.35%、81.48%(P<0.001)。结论我院3类神经内分泌抑制剂使用较规范,但与指南尚有差距,临床药师干预能提高推荐药物的使用率和达标率。Objective To investigate the use of three types of neuroendocrine inhibitors in patients with chronic systolic heart failure before and after intervention by clinical pharmacists.Methods Patients with chronic systolic heart failure receiving the intervention of clinical pharmacists were collected;the clinical characteristics of the patients and the application of neuroendocrine inhibitors were statistically analyzed.The clinical pharmacists performed intervention according to the guideline evaluation standard.Results After intervention,the medication rate on discharge of ACEI/ARB,ACEI,β-RI,MRA,ACEI/ARB+β-RI+MRA,ACEI+β-RI+MRA,ACEI/ARB+β-RI,ACEI+β-RI(83.10%,42.62%,88.57%,66.90%,46.30%,24.76%,26.90%,14.05%)increased significantly(P<0.05).After intervention,the medication rate on discharge of ARB decreased from being higher than ACEI(34.34%vs.32.97%)before intervention to being lower than ACEI(40.48%vs.42.62%).The dose reaching rate of ACEI/ARB andβ-RI increased significantly from 30.20%and 40.91%to 71.35%and 81.48%(P<0.001).Conclusion The use of three types of neuroendocrine inhibitors in our hospital is relatively standard,but there is still a gap with the guidelines.The intervention of clinical pharmacists can improve the use rate and the standardization rate of recommended drugs.

关 键 词：慢性心力衰竭 神经内分泌抑制剂 临床药师 达标剂量 

分 类 号：R541.6[医药卫生—心血管疾病]