老年慢性心力衰竭患者出院带药抗胆碱能药物评价  

Evaluation of anticholinergic medications at discharge in elderly patients with chronic heart failure

作　　者：郑方芳[1] 靳晶晶 任艳丽 张椿英 赵美 孙爽 陈红[1] 宋俊贤[1] Zheng Fangfang;Jin Jingjing;Ren Yanli;Zhang Chunying;Zhao Mei;Sun Shuang;Chen Hong;Song Junxian(Department of Cardiovascular Diseases,Peking University People's Hospital,Beijing 100044,China)

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

出　　处：《中华老年心脑血管病杂志》2025年第3期294-297,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的分析老年慢性心力衰竭患者出院带药中抗胆碱能药物使用情况及其相关危险因素。方法收集2020年1月1日至2023年12月31日北京大学人民医院心血管内科住院的老年慢性心力衰竭患者240例,根据抗胆碱能认知负荷量表(anticholinergic cognitive burden,ACB)评分分为抗胆碱能组223例(ACB评分≥1分)和非抗胆碱能组17例(ACB评分0分)。应用ACB评分对老年慢性心力衰竭患者抗胆碱能负担进行量化,采用logistic回归分析抗胆碱能负担与各相关因素的关系。结果抗胆碱能组年龄明显低于非抗胆碱能组[(75.17±7.21)岁vs(79.12±8.75)岁,P<0.05],出院带药种类明显高于非抗胆碱能组[8(6,10)种vs 5(4,7)种,P<0.01]。logistic回归分析显示,出院带药种类是老年慢性心力衰竭患者抗胆碱能负担增加的独立危险因素(OR=1.575,95%CI:1.249~1.986,P=0.001)。结论老年慢性心力衰竭患者使用抗胆碱能药物比例较高。临床上应重点关注多重用药,以降低抗胆碱能药物所致不良事件发生率。Objective To analyze the use of anticholinergic medications at discharge among elderly patients with chronic heart failure(CHF)and its associated risk factors.Methods Clinical data of 240 elderly CHF patients admitted in our Department of Cardiovascular Diseases between January 1,2020,and December 31,2023 were colloected.Based on ACB score,they were divided into an anticholinergic group(ACB score≥1,223 cases)and a non-anticholinergic group(ACB score of O,17 cases).Using the ACB score,the anticholinergic burden was quantified,and the relationship between anticholinergic burden and various related factors was analyzed using logistic regression.Results The anticholinergic group had significantly younger age[(75.17±7.21)years s(79.12±8.75)years,P<0.05],and larger number of discharge medications[8(6,10)vs 5(4,7),P<0.01]when compared with the non-anticholinergic group.Logistic regression analysis showed that the number of discharge medications was an independent risk factor for increased anticholinergic burden in the elderly CHF patients(OR=1.575,95%CI:1.249-1.986,P=0.001).Conclusion The proportion of elderly CHF patients using anticholinergic medications is relatively high.Clinically,special attention should be given to polypharmacy to reduce the incidence of adverse events caused by anticholinergic drugs.

关 键 词：心力衰竭 胆碱能拮抗剂 药物相关性副作用和不良反应 意外跌倒 

分 类 号：R541.6[医药卫生—心血管疾病]