高血压门诊患者22399例分析

目的分析在首都医科大学附属复兴医院门诊各科室就诊的高血压患者数量、分布情况、用药情况以及药费金额,分析β受体阻滞剂在该院使用的各类降压药中所处的地位。方法利用"东华医院信息系统"门诊医师工作站收集复兴医院2007年7月26日至2008年1月31日门诊各科室收治22399例高血压患者的性别、年龄、血压分级等就诊资料及用药情况、药费金额。将患者就诊科室分为心血管内科、非心血管内科、非内科专业3个组,根据医院门诊药房备药情况将降压药物分为β受体阻滞剂、α受体阻滞剂、血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)、钙拮抗剂、利尿剂、中成药、传统复方降压药物8类。分析3组患者血压分级、年龄、性别等一般资料,不同类型降压药物使用情况及药费金额之间的差异。结果在门诊就诊的女性高血压患者多于男性患者(53.77%vs46.33%),心血管内科组高血压3级患者明显多于非心内科组及非内科专业组(P0.001),其西药费次均金额亦最高(296.75元),而中成药次均金额最少(0.00元)。在非内科专业组中,中成药次均金额明显多于西药费(P0.001)。在非心内科组与非内科专业组中处方量最大的前3种降压药物依次为钙拮抗剂、β受体阻滞剂、ACEI,心血管内科门诊处方量最大的降压药物依次为β受体阻滞剂、钙拮抗剂、利尿剂。结论心内科医师更多地在指南范围内选择降压药物,心血管内科组在降压治疗中中成药使用量明显少于非心内科组及非内科专业组。目前在复兴医院β受体阻滞剂仍作为一线降压药物被使用。

Hypertension:analysis of data of 22 399 outpatients

Objective To analyze the number,distribution,drug use and drug cost of hypertension patients in outpatient departments in Fuxing Hospital Affiliated to Capital Medical University,and to analyze the administration of β receptor blockers in the hospital. Methods Donghua Hospital Information System was used to collect the data of 22 399 hypertension patients in outpatient departments from July 26,2007 to January 31,2008,including sex,age,blood pressure grade,drug administration,and drug cost. According to the specific alities of the physicians in outpatient department they visited,the patients were divided into 3 groups： cardiovascular group,non-cardiovascular group,and non-internal medicine group. The used antihypertensive drugs were divided into 8 types,including β receptor blockers,α receptor blockers,angiotensin-converting enzyme inhibitors （ACEI）,angiotensin-receptor antagonists （ARB）,calcium antagonists,diuretics,traditional Chinese materia medica（TCMM）,and traditional antihypertensive drug compounds. The general data of the patients,such as blood pressure grade,age,sex,etc,and the administration of different types of antihypertensive drugs were compared among 3 groups. Results In the 3 groups,there were more female hypertension patients than male ones （53.77% vs 46.33%,P0.01）. There were more patients with grade Ⅲ hypertension in cardiovascular group than in non-cardiovascular group and non-internal medicine group（P0.01）. The mean other than TCMM drug cost per visit was the highest （RMB 296.75 yuan）,and the mean TCMM cost per visit was the lowest （RMB 0.00 yuan） in cardiovascular group. In non-internal medicine group,the mean TCMM cost per visit was higher than the mean other than TCMM drug cost per visit（P0.01）. The first 3 most commonly prescribed drugs were calcium antagonist,β receptor blockers,and ACEI sequentially in non-cardiovascular and non-internal medicine groups,vs β receptor blockers,calcium antagonists,and diuretics sequentially in cardiovascular group. Conclusion The cardiovascular physicians generally prescribe antihypertensive drugs according to the guide. The TCMM is less used in cardiovascular group than in other two groups. Currently,in Fuxing Hospital,β receptor blockers are the first choice among all antihypertensive drugs.