天津医药

• 药物临床观察 • 上一篇    下一篇

从最新中国高血压指南观察分析大样本门诊处方

闫鹏丽1,2,王林3   

  1. 1. 天津市西青区杨柳青西青343号西青医院综合内科（老年病科）
    2. 天津医科大学第二医院干部保健科
    3. 天津医科大学第二医院
  • 收稿日期:2013-12-10 修回日期:2013-12-25 出版日期:2014-05-15 发布日期:2014-05-15
  • 通讯作者: 王林

Adherence to the latest national guideline of china to analyze the patterns of outpatient prescription on large sample

PengLi YAN1,2,   

  • Received:2013-12-10 Revised:2013-12-25 Published:2014-05-15 Online:2014-05-15

PDF (PC)

2782

摘要： [摘要] 目的 调查分析天津市某三级甲等医院门诊抗高血压处方，分析其与《中国高血压指南2010》（以下简称指南）的差距与不足，以期提高高血压控制率。方法 回顾性调查天津市某三级甲等医院2012年1-12月门诊高血压电子处方154262例，统计患者常用降压药物及联合用药情况，并根据患者年龄、性别、高血压分级、科室、季节等进行分组统计患者联合用药情况。结果 1.门诊最常用的降压药物为钙离子拮抗剂（52.3%），其后依次为血管紧张素II受体拮抗剂（34.0%），β受体阻滞剂（25.9%），血管紧张素转化酶抑制剂（12.1%），固定复方制剂（11.0%），利尿剂（1.4%）。2.门诊处方联合用药少于单药治疗（43.9% vs 56.1%）并且应用有指南不常规推荐用药方案（大于4.4%）。3.分组分析显示3级高血压联合用药高于2级高血压、1级高血压（44.5% vs 37.7% P<0.01）；心内科联合用药高于其他科室（均P<0.01)；老年患者较非老年患者更趋向于联合用药（P<0.01）；夏季处方数少于春、秋、冬季，且夏季联合用药少于春、秋、冬季(均P<0.01)。结论 门诊抗高血压处方联合用药比例偏低，利尿剂使用不足，用药方案与指南要求存在一定差距，需适当增加利尿剂及联合用药比例。

关键词: 门诊处方, 抗高血压药物, 高血压指南, 联合用药

Abstract: [Abstract] Objective To analyze the antihypertensive drug patterns of outpatients from one Grade 3A hospitals of TianJin and analyze the gap and deficiency comparing with the guidelines of china to improve the control rates of hypertension. Methods In this retrospective survey of a Grade 3A hospital ,A total of 154262 hypertension electronic prescriptions of outpatients were enrolled and varied by gender, age, seasons, drug kinds, high blood pressure level group for statistics and analysis, as the same time ,the common used patterns and the condition of combination therapy were counted. Results 1.Of the patient， most patients were receiving calcium channel blockers(52.3%）, followed by angiotensin receptor blockers (34.0%), beta-blockers (25.9%), angiotensin- converting enzyme inhibitors (12.1%), fixed-dose combination(11.0%) and diuretics (1.4%).2. Combination therapy were less than monotherapy(43.9% vs 56.1%）and there were some prescriptions which the Guideline of China do not recommend (more than 4. 4%).3.The combination therapy of stage 3 hypertension was higher than stage 1or stage 2 hypertension（44.5% vs 37.7% P<0.01）; The combinations rate of Cardiology was the highest（P<0.01）; the elderly patients tend to use more combination therapy than non-eldly patients（P<0.01）.3.The prescriptions in summer were lowest than other seasons either alone or in combinations (P <0.01).Conclusion The combination therapy and the diuretic use were insufficient. These findings indicate the existence of a gap between clinical practice and the Guideline.

Key words: outpatient prescription, antihypertensive drugs, Guideline, combination therapy