Evaluation Of The Drug Treatment Of Patients With Chronic Heart Failure

Objectives To analyze the risk factors(including causes and incentives)and clinical features of chronic cardiac insufficiency,evaluate the therapeutic effects of the standardized treatment drugs for chronic cardiac insufficiency proposed in the guidelines,and discuss the normative medical treatment of patients with chronic cardiac insufficiency.Methods A retrospective study of clinical research methods was used to continuously collect patients with chronic heart failure who were hospitalized in the Department of Cardiology,Affiliated Hospital of North China University of Technology from 2014-02-01 to 2016-01-31,and strictly followed the inclusion and exclusion criteria.468 patients were included.A uniform questionnaire was designed.The selected patients were divided into three groups based on the cardiac function classification(NYHA classification),namely heart function class II,heart function class III,and heart function class IV.The records included basic demographic data,The medical history,laboratory examination data,and imaging examination data were used to study the risk factors(including causes and incentives)and clinical features of chronic cardiac insufficiency,and to observe the standardization of drug treatment for patients.All data were created using Epi Data3.0 database,using SPSS17.0 software package for statistical analysis.Measured data were expressed as mean(standard deviation).Paired t-test was used for comparison between groups.Count data were expressed as frequency(%)and ?2 test was used.Differences in mean among the three groups were analyzed by variance,and patients were evaluated according to the guidelines and prescribed medications.The effect of each index's compliance and non-standardized treatment was statistically significant at P<0.05(bilateral).Results 1 There were 26 patients(5.6%)with grade II heart function,9(34.6%)males,and a mean age(69.65±4.92)years;186(39.7%)patients with grade III heart function,and 100(53.8%)males.The mean age was(71.72±11.57)years old;256 heart function class IV patients,133 men(52.0%),and mean age(73.87±11.47)years old.2 Basic etiological analysis among the three groups: 17 patients(65.4%)with coronary heart disease in grade II heart function group,3 patients(11.5%)with hypertensive heart disease,1(3.8%)with cardiomyopathy,and 2 patients with valvular heart disease(7.7%),0 cases of congenital heart disease(0%);132 cases(71.0%)of coronary heart disease in class III heart function,15 cases of hypertensive heart disease(16.1%),11 cases of cardiomyopathy(5.9%),Valvular heart disease in 12 cases(6.5%),congenital heart disease in 1 case(0.5%);cardiac function in class IV coronary artery disease in 180 cases(70.3%),hypertensive heart disease in 21 cases(8.2%),cardiomyopathy Thirteen patients(5.1%)had valvular heart disease in 20 cases(7.8%)and congenital heart disease in 2 cases(0.8%).The difference was not statistically significant(P>0.05).3 Incentives: Patients with heart function II had smoking history in 6 patients(23%)and drinking history in 4 patients(15.4%);heart function in III patients had smoking history in 53 patients(28.5%)and drinking history in 35 patients(18.8 %);Heart function group IV patients had smoking history in 79 cases(30.9%),drinking history in 41 cases(16.0%),smoking history,drinking history had no statistical significance(P> 0.05);risk factors: heart function II Grade 2 old myocardial infarction(7.7%),0 cases of acute myocardial infarction(0%),6 cases of hypertension(7.7%),1 case of diabetes(3.8%),0 cases of hyperlipidemia(0%)Cardiac function III group old myocardial infarction in 38 cases(20.4%),9 cases of acute myocardial infarction(4.8%),30 cases of hypertension(16.1%),76 cases of diabetes(40.9%),3 cases of hyperlipidemia(16.1);In the heart function group IV,58 cases(22.7%)of old myocardial infarction,4 cases of acute myocardial infarction(1.5%),41 cases of hypertension(16.0%),85 cases of diabetes(33.2%),hyperlipemia 2 cases(0.78%),hyperlipidemia,acute myocardial infarction and old myocardial infarction three groups of heart function comparison,P> 0.05;hypertension and diabetes in the three groups of heart function ratio,P<0.05.4 Comparison of echocardiographic indicators: comparison of patients with heart function class II,heart function class III,and heart function class IV,LAD: cardiac function class IV> cardiac function class III> heart function class II The difference was statistically significant(P<0.05);LVDD: cardiac function class IV> cardiac function class III> cardiac function class II,and the difference was statistically significant(P<0.05),LVEF: cardiac function IV Grade group<Heart function III group<Heart function II group,and the difference was statistically significant(P<0.05).5 Patients with varying degrees of cardiac function were treated with standardized ACE inhibitors,betablockers,and aldosterone receptor antagonists(mean weights were met): ACEI use rate was 100% in grade II cardiac function and ?-blocker use rate 96.2%,the use of aldosterone receptor antagonists was 98.4%,the combined use of three drugs was 88.5%;the use of ACEI was 99.5% in heart function III grade,the use rate of beta blockers was 98.9%,and aldosterone receptor antagonists The rate of use was 98.4%.The combined use of the three drugs was 96.8%;the use of ACEI was 98.0% in class IV of heart function,the rate of use of beta blockers was 98.4%,and the rate of use of aldosterone receptor antagonists was 96.9%.The utilization rate is 94.1%.It can be seen that most of the patients with different grades of cardiac functional grading used the combination of the three drugs in the treatment of chronic heart failure,and there was no statistically significant difference in the use of standardized treatment regimens in grade II,grade III,and grade IV cardiac function.(P>0.05).6 Analysis of laboratory parameters in patients with grade II cardiac function,grade III of cardiac function,and grade IV of cardiac function: The differences between HDL-C,GLU,and BNP groups were statistically significant(P<0.05),TC,TG,and LDLC.TP,TBIL,IBIL,ALT,ALB,DBIL,AST,Cr,BUN,systolic blood pressure,diastolic blood pressure,and heart rate were not statistically significant(P>0.05)7 Heart function class II,heart function class III,and heart function class IV Analysis of therapeutic effects of combination of ACEI,?-blockers and aldosterone receptor antagonists in groups within each group: no statistical analysis of TP,DBIL,TC,TG before and after standardized treatment with three drugs Significance(P>0.05),ALB,TBIL,IBIL,ALT,AST,HDL,LDL,BUN,Cr,GLU,systolic blood pressure,diastolic blood pressure,heart rate,BNP and other indicators have statistical significance after standardized treatment(P <0.05).8 Patients with Grade II heart function,Class III cardiac function,and Class IV cardiac function use diuretics,inotropes,and blood vessels based on the combined use of three drugs: ACEI,beta-blockers,and aldosterone receptor antagonists The number of cases of dilators,lipid-lowering agents,antiplatelet agents,Chinese medicines,and freeze-dried recombinant human brain natriuretic peptides(new active factors): The use of proprietary Chinese medicines in heart failure at different levels was statistically significant(P<0.05);diuretics,inotropes,vasodilators,lipid-lowering drugs,antiplatelet drugs,and new active factors and other drugs in different degrees of heart failure were not statistically significant(P> 0.05).8 There was no significant difference in TC,TG,HDL-C,GLU,LDL-C between HF-REF group and HF-PEF group(P<0.05).The levels of TBIL,DBIL,ALT,AST,Cr,BUN and BNP in HF-REF group were higher than those in HF-PEF(P<0.05).Albumin levels in the HF-PEF group were higher than those in the HF-REF group(P<0.05).Conclusions 1 The underlying cause of chronic heart failure in different degrees is coronary heart disease.2 Most of the patients in the clinic were treated with three drugs based on ACEI,beta-blockers and aldosterone receptor antagonists.3 Drug treatment regimens have a significant effect on heart failure with varying degrees of severity.