老年慢性冠脉综合征患者入院前他汀类药物使用及LDL-C控制情况分析  

Prehospital statin use and low-density lipoprotein cholesterol at admission in older patients with chronic coronary syndrome

作　　者：赵美 郑方芳[2] 宋俊贤[2] 黄琳[1] 封宇飞 ZHAO Mei;ZHENG Fang-fang;SONG Jun-xian;HUANG Lin;FENG Yu-fei(Department of Pharmacy,Peking University People's Hospital,Beijing 100044,China;Department of Cardiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院药剂科,北京100044 [2]北京大学人民医院心血管内科,北京100044

出　　处：《中国医院药学杂志》2021年第13期1327-1331,共5页Chinese Journal of Hospital Pharmacy

基　　金：北京市科技计划项目(编号:Z161100000116071)。

摘　　要：目的:了解老年慢性冠脉综合征(chronic coronary syndrome,CCS)患者入院前他汀类药物使用及低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)达标情况,分析影响达标的相关因素,为CCS血脂管理提供一定的参考。方法:选取2019年10月1日至2020年9月30日心血管内科收治的老年CCS患者345例,进行横断面、非干预性调查。结果:老年CCS患者入院前他汀类药物使用率66.4%(单用他汀94.8%,联合治疗5.2%),以中等强度他汀为主。LDL-C达标率39.1%,其中74.1%的患者入院前应用他汀类药物。多因素回归分析证实入院前应用他汀类药物促进LDL-C达标,整体及用药组均提示女性及病史5年以上降低LDL-C达标率。出院时他汀类药物处方上升至94.5%,联合治疗占10.7%。结论:老年CCS患者LDL-C达标率低,他汀类药物使用与指南推荐仍有差距;建议临床药师参与或加强对老年CCS患者血脂的综合规范化管理。OBJECTIVE To evaluate prehospital statin use and low-density lipoprotein cholesterol(LDL-C)levels at admission in older patients with chronic coronary syndrome(CCS)and determine the relevant influencing factors.METHODS A cross-sectional study was conducted for 345 older CCS inpatients admitted between October 1,2019 and September 30,2020.RESULTS Among them,66.4%received statins prior to hospitalization(statin monotherapy 94.8%,combination 5.2%).Moderate intensity statins were widely prescribed.A total of 39.1%patients attained the goal of LDL-C and 74.1%ingested statins.In multivariable analysis,prehospital statin use was more likely to attain the goal while females and those with a disease history>5 years were less likely to do so in both whole and statins groups.At discharge,94.5%of patients received statins and combination treatment accounted for 10.7%.CONCLUSION A large majority of older CCS patients fail to attain the LDL-C target.There is a gap between real-world use of statins and guideline recommendation.Clinical pharmacists are urged to participate in or strength lipid management for older CCS patients.

关 键 词：老年患者 慢性冠脉综合征 他汀 低密度脂蛋白胆固醇 

分 类 号：R969.3[医药卫生—药理学]