某院稳定冠状动脉粥样硬化性心脏病心率控制和β受体阻滞药物使用情况调查

Survey on status of heart rate control and β-blocker use in patients with stable coronary artery disease

摘要:

目的调查该院稳定性冠状动脉粥样硬化性心脏病（冠心病）患者的心率控制和β受体阻滞药物使用情况，探讨其影响因素。方法选取2013 年1 月-2015 年12 月于门诊就诊的126 例稳定性冠心病患者作为调查对象。根据其静息心率分为心率控制不良组（≥70 次/min）和良好组（<70 次/min），根据其是否服用β受体阻滞剂分为服用组和未服用组，比较两组之间的临床资料，采用多因素Logistic 回归分析筛选出患者心率控制不良与未服用β受体阻滞剂的影响因素。结果全部患者心率控制不良率为55.6%，多因素Logistic回归分析结果表明，吸烟、糖尿病、收缩压（SBP）是患者出现心率控制不良的危险因素（P <0.05），经皮冠状动脉介入治疗（PCI）是其保护因素（P <0.05）。全部患者中有29 例（23.0%）患者未服用β受体阻滞剂。多因素Logistic回归分析结果表明，年龄、难以耐受β受体阻滞剂或有禁忌证是患者未服用β受体阻滞剂的危险因素（P <0.05），急性心肌梗死（AMI）、PCI是其保护因素（P <0.05）。结论该研究中β受体阻滞剂的的应用率虽然较高，但心率控制的整体状况不甚理想，超过一半的患者静息心率超过70 次/min，且吸烟、糖尿病、SBP升高、未行PCI者的心率控制不良风险更高。

Abstract:

Objective To investigate the status of heart rate control and β-blocker use in patients with stable coronary artery disease in our hospital, and then discuss its influence factors. Methods Totally 126 patients with stable coronary artery disease between January 2013 and December 2015 were enrolled for the research objects, then they were divided into bad control group (≥70 times/min) and good control group (< 70 times/min) according to its resting heart rate, and into taking group and not-taking group according to whether taking β-blocker or not.Clinical data were compared between the two groups, then multiple logistic regression analysis was performed to screen out the influencing factors of bad control of heart rate and not taking β-blocker. Results The rate of bad control of heart rate was 55.6%. The results of multiple logistic regression analysis showed that history of smoking, diabetes and SBP were the independent risk factors for bad control of heart rate (P < 0.05), the history of percutaneous coronary intervention (PCI) was the independent protective factor (P < 0.05). Of the 126 patients, 29(23.0%) did not take β-blocker. Results of multiple logistic regression analysis showed that age, intolerance to β-blockers or contraindications of β-blockers were the independent risk factors of not-taking β-blockers (P < 0.05),and the history of acute myocardium infarction (AMI) and PCI history were its independent protective factors (P <0.05). Conclusions Although the utility rate of β-blocker is high, the overall condition of the heart rate control is not ideal. Resting heart rate of more than half of patients is more than 70 times/min, and patients with history of smoking, diabetes, SBP, and without history of PCI have higher risk of bad control of heart rate.