鞍山市2015 — 2018年高血压住院患者药物流行病学特征分析

孟彤; 张镇江; 贾亦真; 谢晶; 范正悦; 宗晓郁; 王俊彦; 贾敏; 张灵健; 宫建

doi:10.11847/zgggws1139466

鞍山市2015 — 2018年高血压住院患者药物流行病学特征分析

Antihypertensive regimen among primary hypertension inpatients, 2015 – 2018: an analysis on medical records of three tertiary hospitals in Anshan city

摘要

摘要:
目的分析辽宁省鞍山市2015 — 2018年高血压住院患者的药物流行病学特征，为进一步评估高血压患者的合理用药提供参考依据。
方法于2019年6 — 12月采用分层随机抽样方法通过鞍山市某3家三级甲等医院信息系统随机抽取2015、2016、2017和2018年高血压住院患者的病历资料各300份进行高血压住院患者临床特征及降压药物使用情况的分析。
结果鞍山市2015 — 2018年住院治疗的3600例高血压患者中，1级高血压患者525例（14.58%），2级高血压患者1032例（28.67%），3级高血压患者2043例（56.75%）；伴发疾病包括左心室肥厚762例（21.17%）、颈动脉硬化301例（8.36%）、冠心病514例（14.28%）、心力衰竭324例（9.00%）、缺血性脑卒中447例（12.42%）、出血性脑卒中269例（7.47%）、慢性肾脏病227例（6.31%）；使用降压药物单药治疗者1004例（27.89%），使用联合用药治疗者2596例（72.11%）；单药治疗方案中，采用钙离子拮抗剂（CCB）治疗方案的构成比最高（32.37%），其次为采用血管紧张素转化酶抑制剂（ACEI）治疗方案（20.92%）；联合用药治疗方案中，采用ACEI/血管紧张素Ⅱ受体拮抗剂（ARB） + CCB + 利尿剂治疗方案的构成比最高（22.65%），其次为采用ACEI/ARB + β – 受体阻滞剂 + CCB治疗方案（22.61%）。
结论鞍山市2015 — 2018年高血压住院患者以3级高血压患者居多，多伴发左心室肥厚、冠心病、缺血性脑卒中等疾病，单药治疗以CCB类药物为主，联合用药治疗以ACEI/ARB + CCB + 利尿剂方案为主。

Abstract:
Objective To examine antihypertensive regimens among primary hypertension inpatients during 2015 – 2018 in Anshan city of Liaoning province for evaluating rational medication of hypertensive patients.
Methods Using stratified random sampling through hospital information systems, we extracted medical records of 3 600 primary hypertension patients hospitalized at three tertiary first-class hospitals during 2015 – 2018 (300 records/per year/per hospital) in Anshan city. The clinical characteristics and antihypertensive regimens of the inpatients were statistically analyzed.
Results Of all the inpatients, 525 (14.58%),1032 (28.67%), and 2043 (56.75%) were diagnosed with hypertension of stage I, II, and III, respectively. The proportions of the inpatients having concomitant diseases were 21.17% for left ventricular hypertrophy, 8.36% for carotid atherosclerosis, 14.28% for coronary heart disease, 9.00% for heart failure, 12.42% for ischemic stroke, 7.47% for hemorrhagic stroke, and 6.31% for chronic kidney disease. Among all the inpatients during the hospitalizations, 1 004 (27.89%) had single antihypertensive medication and 2 596 (72.11%) had combined antihypertensive medication. Among the monotherapy regimens, calciumion antagonists (CCB) was the most frequently used drug in 325 (32.37%)of the inpatients, followed by angiotensin converting enzyme inhibitors (ACEI) in 210 (20.92%) of the inpatients. Of the inpatients with the combined regimens, 588 (22.65%) had the medication of ACEI/angiotensin receptor blocker (ARB) plus CCB plus diuretic and 587 (22.61%) had the medication of ）ACEI/ARB plus β-receptor blocker plus CCB. The antihypertensive regimens differed significantly by hypertension stage among the inpatients (χ² = 1 922.86, P < 0.001).
Conclusion For the primary hypertensive patients hospitalized during 2015 – 2018 in Anshan city, more than a half had stage III hypertension and left ventricular hypertrophy, coronary artery disease, and ischemic stroke were major concomitant diseases; CCB was a main monotherapy and ACEI/ARB plus CCB plus diuretic was a main combined antihypertensive regimen in the treatment of the inpatients during hospitalization.

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