CAJ | 학술논문

目的了解内科医生掌握我国心力衰竭(心衰)指南主要知识的程度,为心衰知识的推广转化工作提供参考.方法依据我国2007年“慢性心力衰竭诊断治疗指南”和2010年“急性心力衰竭诊断治疗指南”编写心衰知识问卷,问题形式包括选择题20道和填空题10道.以回答正确率表示各知识点被掌握的程度.结果400名来自北京等多个城市的内科医生完成了调查问卷,其中心血管病专科医生208人,非心血管病专科医生192人.在20道选择题中,回答正确率在60％以下、60％～80％之间和80％以上的问题分别为8个(40％)、8个(40％)和4个(20％).关于10个具体的血管紧张素转换酶抑制剂(ACEI)、血管紧张素Ⅱ受体拮抗剂(ARB)和β受体阻滞剂的目标剂量的填空题,正确率只有49％.回答正确率低于60％的8个选择题分别是:①心肌重构的具体内容,②对诊断心衰有提示意义的症状,③对诊断心衰有肯定意义的检查,④美国心脏学会(AHA)心衰分期,⑤急性心衰的Forrester血液动力学分级,⑥ACEI和ARB在心衰患者中的应用目的,⑦应用ACEI或ARB有循证医学证据的具体心脏病,⑧ACEI、ARB和β受体阻滞剂的使用方法.结论我国内科医生总体而言对心衰指南掌握程度较差,需加强心衰知识的系统学习.
목적 료해내과의생장악아국심력쇠갈(심쇠)지남주요지식적정도,위심쇠지식적추엄전화공작제공삼고.방법 의거아국2007년“만성심력쇠갈진단치료지남”화2010년“급성심력쇠갈진단치료지남”편사심쇠지식문권,문제형식포괄선택제20도화전공제10도.이회답정학솔표시각지식점피장악적정도.결과400명래자북경등다개성시적내과의생완성료조사문권,기중심혈관병전과의생208인,비심혈관병전과의생192인.재20도선택제중,회답정학솔재60％이하、60％～80％지간화80％이상적문제분별위8개(40％)、8개(40％)화4개(20％).관우10개구체적혈관긴장소전환매억제제(ACEI)、혈관긴장소Ⅱ수체길항제(ARB)화β수체조체제적목표제량적전공제,정학솔지유49％.회답정학솔저우60％적8개선택제분별시:①심기중구적구체내용,②대진단심쇠유제시의의적증상,③대진단심쇠유긍정의의적검사,④미국심장학회(AHA)심쇠분기,⑤급성심쇠적Forrester혈액동역학분급,⑥ACEI화ARB재심쇠환자중적응용목적,⑦응용ACEI혹ARB유순증의학증거적구체심장병,⑧ACEI、ARB화β수체조체제적사용방법.결론 아국내과의생총체이언대심쇠지남장악정도교차,수가강심쇠지식적계통학습.
Objective To obtain the knowledge status on recommended heart failure (HF) guidelines among Chinese physicians.Methods Questionnaire on heart failure including 20 multiple choice questions and 10 fill in the blank questions was designed based on the Chinese guidelines for the diagnosis and treatment of chronic heart failure in 2007 and the Chinese guidelines for the diagnosis and treatment of acute heart failure in 2010.The rate of correct answer for each item was calculated and compared among physicians specialized for cardiovascular diseases and not.Results The Questionnaire was completed in 400 physicians,including 208 physician specialized for cardiovascular disease and 192 physicians not specialized in cardiovascular disease.The rate of correct answer for 20 multiple choice questions was lower than 60％ in 8 questions,60％-80％ in 8 questions,higher than 80％ in 4 questions.The rate of correct answers for 10 fill in the blank questions focusing on the aimed dosage of 10 ACEI/ARB/β-blockers was 49％.The 8 multiple choice questions with correct answer rate ＜ 60％ are detailed items of myocardial remodeling,symptoms suggestive of HF,diagnosis tools for patients with suspected HF,the AHA stages of heart failure,the Forrester's hemodynamic classes of acute heart failure,the goals of ACEI/ARBs treatment in patients with HF,names of heart diseases which might benefit from ACEI/ARBs treatment defined by evidenced based medicine,and detailed application methods of ACEL/ARBs and β-blockers for HF patients.In general,the rate of correct answer was significantly higher in physicians specialized for cardiovascular disease compared physicians not specialized for cardiovascular disease.Conclusion There is a considerable knowledge gap on the Chinese guidelines for the diagnosis and treatment of chronic heart failure and the Chinese guidelines for the diagnosis and treatment of acute heart failure among Chinese physicians.Efforts must be made to educate physicians to improve their knowledge and improve HF patient care.