Retrospective analysis of drug treatment of in-patients with chronic heart failure in different regions / 中国综合临床

ABSTRACT

Objective To compare drug therapy in patients suffering from chronic heart failure between Tianjin and Kashi region of Xinjiang autonomous region and to analyse their disparities in drug uses by guideline between the two regions.Methods All data were retrospectively taken from the hospitalized chronic heart failure cases from June 2005 to June 2006 in the 2nd Hospital of Tianjin Medical University and the 2nd People's Hospital of Kashi in Xinjiang respectively.The heart functions level NYHA Ⅱ-Ⅳ were recorded for analysis of drug use in the two regions.Results 749 cases were enrolled,491 from Tinajin and 258 from Kashi of Xinjiang.The average age of group Tianjin[(70.39±10.84)yrs]was older than that[(62.91±12.54)yrs]of group Kashi(t=8.488,P＜0.01).The distribution of≥165 cases in the group Tianjin(75.6%)was higher than that of group Kashi(51.2%)(X2=45.642,P＜0.01).The male cases in group Tianjinwere 264(53.8%)andthatwere 134(51.9%)in group Kashi with no significant differences in sex distribution between the two groups(P＞0.05).The first three etiological diseases were coronary heart disease(84.9%),rheumatic heart disease(5.9%)and dilated cardiomyopathy (3.3%)in group Tianjin,and that were coronary heart disease(63.2%),pulmonary heart disease(19.8%)and dilated eardiomyopathy(6.6%)in group Kashi respectively.The proportions of level NYHA Ⅱ,Ⅲ,Ⅳ on admission were 29.7%,39.1%and 31.2%in group Tianjin respectively,and that were 15.5%,39.5%and 45.0%in group Kashi respectively,with significant difference in heart function levels between the two groups(X2=22.770,P＜0.01).Theusages of nitrides and β-blockers in group Tianjin were more than that in group Kashi(both P＜0.01).The usages of diuretics,digitalis was more in group Kashi(all P＜0.01).There was no difference in ACEI usages between the two groups.The dosages of drugs in group Tianjin achieved the target dosages by the guideline and the dosages in group Kashi did not achieve the targets.The use frequency of β-blockers was more in male cases and＜65yrs respectively of group Tianjin.The usage frequency of uretics and aldosterone antagonist were more in＜65yrs cases of group Kashi and the usages of nitrides,ACEI,B-blockers,calcium antagonists,aldosterone antagonist of male cases were more than that of female cases(all P＜0.05)in this group.The usages of uretics,digitalis,aldostemne antagonist increased following the grading of heart function of the two groups(P＜0.05).Moreover the usage of ACEI decreased following the worsen heart function in group Tainjin and this was not the same in group Kashi.Conclusion There are differences in drug medications for chronic heart failure between Tianjin and Kashi.The majority of treatment drugs in Tianjin is approaching the guideline and there is a gap from guideline in Kashi of Xinjiang,especially on the dosage.