高危冠心病患者血管紧张素转换酶抑制剂类药物应用现况调查
고위관심병환자혈관긴장소전환매억제제류약물응용현황조사
ACEI/ARB use among high risk patients with coronary heart disease in China: a cross-sectional study
  • 万方数据
    中华心血管病杂志 중화심혈관병잡지
    Chinese Journal of Cardiology
    2013年 1期 18-22 ,共5页

    刘佳敏%葛蕾%李静%李希%冯芳%张海波%高岩%乌汉毕力格%庞鑫%CHEN Yi-ping%CHEN Zheng-ming%LANDRAY Martin%ARMITAGE Jane%CHEN Fang%蒋立新

    류가민%갈뢰%리정%리희%풍방%장해파%고암%오한필력격%방흠%CHEN Yi-ping%CHEN Zheng-ming%LANDRAY Martin%ARMITAGE Jane%CHEN Fang%장립신

    冠状动脉疾病%治疗结果%横断面研究 冠狀動脈疾病%治療結果%橫斷麵研究
    관상동맥질병%치료결과%횡단면연구
    Coronary disease%Treatment outcome%Cross-sectional study
    目的 了解国内部分医院高危冠心病患者血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)类药物的使用现状,分析影响药物使用的相关因素.方法 分别于2007年及2009年在14个城市的51家医院进行横断面调查,对符合条件的冠心病患者,利用电子问卷采集基线数据,对ACEI/ARB类冠心病二级预防药物的使用情况进行统计描述和分析.结果 在13 078例均应使用ACEI/ARB类药物的冠心病患者中,服用ACEI/ARB类药物的比例仅为45.8％,且病史超过1年的患者服药的比例明显下降.即使是合并糖尿病或高血压的患者服药比例也仅分别为46.1％和56.3％.多元logistic回归分析结果显示性别、合并心肌梗死或高血压病史、实施经皮冠状动脉介入治疗及病程长短是影响ACEI/ARB类药物使用的因素.各种ACEI/ARB类药物中,卡托普利使用最为广泛.结论目前国内冠心病患者ACEI/ARB类药物的使用状况存在明显不足,如何将循证医学证据与临床实践有机结合,让尽可能多的患者从中受益,仍是临床工作者及卫生决策部门面临的重大问题.
    목적 료해국내부분의원고위관심병환자혈관긴장소전환매억제제/혈관긴장소Ⅱ수체길항제(ACEI/ARB)류약물적사용현상,분석영향약물사용적상관인소.방법 분별우2007년급2009년재14개성시적51가의원진행횡단면조사,대부합조건적관심병환자,이용전자문권채집기선수거,대ACEI/ARB류관심병이급예방약물적사용정황진행통계묘술화분석.결과 재13 078례균응사용ACEI/ARB류약물적관심병환자중,복용ACEI/ARB류약물적비례부위45.8％,차병사초과1년적환자복약적비례명현하강.즉사시합병당뇨병혹고혈압적환자복약비례야부분별위46.1％화56.3％.다원logistic회귀분석결과현시성별、합병심기경사혹고혈압병사、실시경피관상동맥개입치료급병정장단시영향ACEI/ARB류약물사용적인소.각충ACEI/ARB류약물중,잡탁보리사용최위엄범.결론목전국내관심병환자ACEI/ARB류약물적사용상황존재명현불족,여하장순증의학증거여림상실천유궤결합,양진가능다적환자종중수익,잉시림상공작자급위생결책부문면림적중대문제.
    Objective This study investigated current use of ACEI/ARB among high risk patients with coronary heart disease (CHD) in China and factors affecting ACEI/ARB use in these patients.Methods This cross-sectional survey was performed between June to December 2007 and May to November 2009 in 51hospitals from 14 cities.The characteristics of patients with established CHD were collected by electronic questionnaire.Results Only 45.8％ high risk CHD patients were taking ACEI/ARB and the ACEI/ARB medication decreased significantly with time after initial CHD diagnosis.ACEI/ARB was taken in 46.1％CHD patients complicated with diabetes mellitus and in 56.3％ CHD patients complicated with hypertension.Logistic regression analysis showed that comorbid hypertension was the strongest factor associated with ACEI/ARB use.In addition,male gender,history of myocardial infarction (MI),PCI and the time after initial CHD diagnosis were independent factors affecting the use of ACEI/ARB.Captopril was the most commonly prescribed ACEI in this cohort.Conclusion ACEI/ARB is underused in secondary prevention among high risk CHD patients in China.It remains a major challenge for healthcare professionals and policy makers tn make efforts on narrowing the gap between evidence and practice.
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문