惠州市某医院冠状动脉粥样硬化性心脏病二级预防用药情况分析  

Analysis of secondary preventive medication for coronary atherosclerotic heart disease in a hospital in Huizhou

作　　者：张婕斐 张旭[2] 刘淑珍[2] 王盼 薛梅 叶锦标[2] 高分飞[1] ZHANG Jiefei;ZHANG Xu;LIU Shuzhen;WANG Pan;XUE Mei;YE Jinbiao;GAO Fenfei(Department of Pharmacology,Shantou University Medical College,Shantou 515041,China;Department of Pharmacy,Huizhou Central People's Hospital,Huizhou 516001,China)

机构地区：[1]汕头大学医学院药理学教研室,广东汕头515041 [2]惠州市中心人民医院药学部,广东惠州516001

出　　处：《汕头大学医学院学报》2023年第2期111-114,119,共5页Journal of Shantou University Medical College

摘　　要：目的:探讨惠州市某医院冠状动脉粥样硬化性心脏病(冠心病)二级预防用药的合理性,为临床合理用药提供参考。方法:抽查2020年1—12月惠州市某三甲医院心血管内科500份冠心病出院病历,分析冠心病二级预防用药情况及其用药合理性。结果:500份病历中,冠心病二级预防用药不足的共194例(38.8%),其中使用率最低为血管紧张素转化酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)/血管紧张素Ⅱ受体阻滞剂(angiotensinⅡreceptor blocker,ARB)(71.0%)。多因素Logistic回归分析显示年龄(OR=1.023,95%CI:1.004~1.041)、是否合并高血压(OR=0.523,95%CI:0.356~0.769)等因素与冠心病二级预防用药不足相关,年龄较大、无合并高血压的患者明显存在二级预防用药不足现象。体重指数(OR=1.073,95%CI:1.010~1.139)、是否合并高血压(OR=1.867,95%CI:1.256~2.776)与冠心病患者ACEI/ARB的使用率相关,体重指数低、无合并高血压患者的ACEI/ARB使用率低。结论:该院冠心病二级预防用药(尤其是ACEI/ARB)不足问题需引起注意。Objective:To investigate the rationality of secondary preventive medication for coronary atherosclerotic heart disease(CHD)in a hospital in Huizhou,and to provide reference for clinical rational drug use.Methods:From January to December 2020,500 medical records of CHD discharged from the Department of Cardiovascular Medicine of a tertiary hospital in Huizhou were randomly checked,and the situation of secondary prevention of CHD and its rationality were analyzed.Results:Among the 500 medical records,there were 194 cases(38.8%)who were under-medicated for secondary prevention of CHD,and the lowest usage rate was angiotensin converting enzyme inhibitor(ACEI)/angiotensinⅡreceptor blocker(ARB)(71.0%).Multivariate Logistic regression analysis showed that factors such as age(OR=1.023,95%CI:1.004-1.041),and hypertension(OR=0.523,95%CI:0.356-0.769)were related to insufficient medication for secondary prevention of CHD.Older patients without hypertension were obviously under-medicated for secondary prevention.Body mass index(OR=1.073,95%CI:1.010-1.139)and hypertension(OR=1.867,95%CI:1.256-2.776)were related to the usage rate of ACEI/ARB in patients with CHD.The usage rate of ACEI/ARB was low in patients with low body mass index and without hypertension.Conclusion:Attention should be paid to the problem of insufficient medication(especially ACEI/ARB)for secondary prevention of CHD in this hospital.

关 键 词：冠心病 二级预防 合理用药 血管紧张素转化酶抑制剂 血管紧张素Ⅱ受体阻滞剂 

分 类 号：R952[医药卫生—药学]