Ma Jin-ping, Wang Lin, Dang Qun, Li Yong-jian, Li Xi-yuan, Zhang Cheng-zong, Li Guang-ping
Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Jan;28(1):78-82.
To investigate drug treatment of inpatients with chronic heart failure(CHF) during the past 30 years in some areas and to provide more information on the treatment strategy of CHF.
In two centers a retrospective study was conducted. All data were taken from the hospitalized cases with chronic heart failure. The medication distributions in different decade, gender, age heart function grade and etiology were analyzed.
5189 cases were enrolled with the ratio of male to female as 1:1.02. The mean age was (62.93 +/- 13.49) years old. The general causes of chronic heart failure were as follows: coronary heart disease (44.2%), rheumatic heart disease (24.1% ) , pulmonary heart disease (19.0%) and cardiomyopathy (4.8%). The admission cardiac function was mostly seen as grade NYHA IlI and IV, and their proportions were 40.6% and 44.5%. Major medication would include nitride (80.0%), diuretics (71.8% ), digitalis (68.1% ), angiotensin conversion enzyme inhibitors (ACEI) (52.2% ) and beta-blockers (19.5% ) etc. Moreover the frequency of above used medication was essentially increasing decade by decade. The major drug treatment of pulmonary heart disease also included diuretics, nitride, digitalis. ACEI was more commonly used in male than in female cases. The frequency of ACEI and ARB were more commonly used in the group > or = 60 years old than that in the group < 60 years old. The administration frequency of beta- blockers had no significant difference among different age and sexes.
The conventional drugs such as nitride, diuretics, digitalis were still dominated the treatment of CHF. Although the administration frequency of ACEI and beta-blockers increased quickly, there had been a great gap between the optimal medical strategy and clinical practice in the management of CHF. Data showed the treatment strategy was changing.
调查过去30年中某些地区慢性心力衰竭（CHF）住院患者的药物治疗情况，为CHF的治疗策略提供更多信息。
在两个中心进行回顾性研究。所有数据均来自慢性心力衰竭住院病例。分析了不同年代、性别、年龄、心功能分级和病因的用药分布情况。
共纳入5189例，男女比例为1:1.02。平均年龄为（62.93±13.49）岁。慢性心力衰竭的常见病因如下：冠心病（44.2%）、风湿性心脏病（24.1%）、肺心病（19.0%）和心肌病（4.8%）。入院时的心功能大多为NYHA III级和IV级，比例分别为40.6%和44.5%。主要用药包括硝酸酯类（80.0%）、利尿剂（71.8%）、洋地黄（68.1%）、血管紧张素转换酶抑制剂（ACEI）（52.2%）和β受体阻滞剂（19.5%）等。此外，上述药物的使用频率基本呈十年递增趋势。肺心病的主要药物治疗也包括利尿剂、硝酸酯类、洋地黄。ACEI在男性病例中的使用频率高于女性。ACEI和ARB在≥60岁组的使用频率高于<60岁组。β受体阻滞剂的给药频率在不同年龄和性别之间无显著差异。
硝酸酯类、利尿剂、洋地黄等传统药物仍主导着CHF的治疗。尽管ACEI和β受体阻滞剂的给药频率迅速增加，但在CHF的管理中，最佳治疗策略与临床实践之间仍存在很大差距。数据显示治疗策略正在发生变化。
