Hillis G S, Trent R J, Winton P, MacLeod A M, Jennings K P
Department of Medicine and Therapeutics, University of Aberdeen, Foresterhill, UK.
QJM. 1996 Feb;89(2):145-50. doi: 10.1093/qjmed/89.2.145.
The benefits of angiotensin-converting enzyme (ACE) inhibition in the management of cardiac failure have been extensively documented. However, little is known about its impact upon the investigation and management of this condition. We assessed how patients diagnosed as having cardiac failure were investigated, which patients were treated with ACE inhibitors and with what dosages. We reviewed the case notes of all 343 patients discharged from Aberdeen Royal Infirmary 1 July-31 December 1992 with a diagnosis of cardiac failure. In addition, a questionnaire was sent to the general practitioners of the 166 patients still alive in October 1994. Only 40% of patients were discharged from hospital on ACE inhibitors. In 58.8%, the diagnosis of cardiac failure was based purely on clinical or radiological grounds. At discharge, 76.1% of patients were on lower doses of ACE inhibitors than those used in the major survival studies; with 68.9% receiving similar doses two years later. The majority of patients with heart failure are under-investigated and under-treated.
血管紧张素转换酶（ACE）抑制剂在心力衰竭治疗中的益处已得到广泛记载。然而，对于其对该病症的检查和治疗的影响却知之甚少。我们评估了被诊断为心力衰竭的患者是如何接受检查的，哪些患者接受了ACE抑制剂治疗以及使用的剂量是多少。我们查阅了1992年7月1日至12月31日从阿伯丁皇家医院出院的所有343例诊断为心力衰竭患者的病历。此外，还向1994年10月仍在世的166例患者的全科医生发送了问卷。只有40%的患者出院时使用了ACE抑制剂。58.8%的心力衰竭诊断纯粹基于临床或影像学依据。出院时，76.1%的患者使用的ACE抑制剂剂量低于主要生存研究中使用的剂量；两年后，68.9%的患者接受了相似剂量的治疗。大多数心力衰竭患者的检查和治疗不足。
