The Influence Of Drug Treatment On Patients With Chronic Heart Failure Complications

Objective:To examine the association of the complications of hospitalized chronic heart failure patients and angiotensin converting enzyme inhibitors(ACEI),β-receptor blockers, angiotensin receptor antagonists(ARB) drug therapy.Methods:All chronic heart failure cases which were hospitalized between July 1973 and July 2007 in the second hospital of Tianjin medical university were collected from medical record library by specialized person. The retrospective index included age, gender, etiology, complications, risk factors, electrolytes, heart function, angiotensin converting enzyme inhibitors(ACEI), P-receptor blockers, angiotensin receptor antagonists(ARB) drug therapy, etc. All data were collected by SPSS13.0. And all data were divided with a decade interval into group A (1973～), group B (1980～), group C (1990～) and group D (2000～2007).Results:6602 cases were enrolled, of which there were men cases 3325 (50.4%) and women cases 3277 (49.6%). Mean age of all cases was 64.56±13.238 years old, which had an increasing tendency with the decade advancing. There was an increasing tendency of hypertension, diabetes mellitus, renal inadequacy, anemia and thyroid disease years after years. While the complications of hepatic cirrhosis, disorder of serum potassium and natrum displayed a decreasing tendency. Drugs used angiotensin converting enzyme inhibitors(ACEI) 53.5%(3531/6602),β-receptor blockers 24.7%(1629/6602), angiotensin receptor antagonists(ARB) 5.1%(338/6602). Diuretics, digitalis, ACEI and P-receptor blockers were the basic medicine used in heart failure, using three or four medicines were growing year after year, and the combine usage of ACEI andβ-receptor blockers and combine usage of ACEI,β-receptor blockers and aldosterone antagonists was also increasing year by year. There was different in the medicine use between group of ages≥60 years old and group of<60 years old withβ-receptor blockers excluded. Group of ages<60 years old used more diuretics, digitalis and positive inotropic than group of ages≥60 years old, while the latter used more nitrates, ACEI, ARB and aldosterone antagonists. It was the same in the use of digitalis, ARB and aldosterone antagonists between male group and female group, however, use of diuretics, nitrates, ACEI,β-receptor blockers, ARB, and the combine of ACEI andβ-receptor blockers, combine of ACEI,β-receptor blockers and aldosterone antagonists, and combine of diuretics, digitalis, ACEI andβ-receptor blockers was more in male group than that of in female group (P<0.05).The use of diuretics, digitalis and nitrates became more and more accompanied by the heart function becoming higher and higher. It was the patients with a heart function at NYHAⅡorⅢclass to use moreβ-receptor blockers. And the combine of ACEI andβ-receptor blockers was used the most in patients with NYHAⅠorⅢclass, the second in NYHAⅡclass, and the least in NYHAⅣclass. The combine of ACEI,β-receptor blockers and aldosterone antagonists was used the most in NYHAⅢorⅣclass. While the combine of diuretics, digitalis, ACEI andβ-receptor blockers was the same among different heart function.Conclusion:It is displayed that diuretics, digitalis and nitrate are the main therapeutic agents in hospitalized patients with chronic heart failure in some territory of Tianjin, the usage of ACEI andβ-receptor blockers are increasing rapidly, which reflexes the attitude changes of clinical doctor. There was a problem how to carry out heart failure guidelines better.