通讯作者: 蔡杰, caijie315@163.com

DOI：10.12201/bmr.202507.00076

Analysis and evaluation of guideline-directed medical therapy in chronic heart failure inpatients with reduced ejection fraction in a third level hospital

• 摘要：目的 调查温岭市中医院慢性射血分数降低的心力衰竭（heart failure with reduced ejection fraction，HFrEF）住院患者指南导向药物治疗（guideline-directed medical therapy，GDMT）的基本情况和合理性，为临床用药提供参考。方法 回顾性分析2022-2024年我院心血管内科收治的HFrEF患者的临床资料和GDMT相关药物血管紧张素受体脑啡肽酶抑制剂（angiotensin receptor neprilysin inhibitor，ARNI）/血管紧张素转化酶抑制剂（angiotensin converting enzyme inhibitor，ACEI）/血管紧张素Ⅱ受体拮抗剂（angiotensin II receptor blocker，ARB）、β受体阻滞剂（β-blocker，BB）、醛固酮受体拮抗剂（mineralocorticoid receptor antagonist，MRA）、钠-葡萄糖协同转运蛋白2抑制剂（sodium-glucose cotransporter-2 inhibitor，SGLT2i）的使用情况，并依据相关指南、共识和药品说明书评价用药合理性。结果 共纳入117例患者，平均年龄（69.62±14.39）岁，其中男性占73.50%；ARNI/ACEI/ARB、BB、MRA和SGLT2i使用率分别为77.78%、63.25%、97.44%和68.38%，目标剂量达标率分别为2.20%、0.00%、100.00%和98.75%；单一、二联、三联和四联用药构成比分别为5.98%、23.08%、29.06%和41.88%。结论 我院慢性HFrEF患者GDMT相关药物使用现状与指南相比仍存在一定差距，BB的使用率较低，ARNI/ACEI/ARB和BB的使用剂量严重不足，MRA存在过度用药情况，GDMT用药规范性有待进一步提高。

  关键词： 射血分数降低的心力衰竭；指南导向药物治疗；用药评价; ; 

   

  Abstract: Objective: To investigate the current status and rationality of guideline-directed medical therapy (GDMT) in inpatients with chronic heart failure with reduced ejection fraction (HFrEF) in Wenling Hospital of Traditional Chinese Medicine, and provide references for clinical drug use. Methods: The clinical date of HFrEF patients admitted to the Department of Cardiology of our hospital and the application of GDMT-related medications including angiotensin receptor neprilysin inhibitor (ARNI) / angiotensin converting enzyme inhibitor (ACEI) / angiotensin II receptor blocker (ARB), β-blocker (BB), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) were retrospectively analyzed from 2022 to 2024. The rationality of drug use were evaluated according to relevant guidelines, consensus and drug instructions. Results: A total of 117 patients were included, among which 73.50% were male, and the average age was (69.62±14.39) years old. The proportion of patients receiving ARNI/ACEI/ARB, BB, MRA and SGLT2i was 77.78%, 63.25%, 97.44% and 68.38%, respectively. The rates of reaching target dose were 2.20%, 0.00%, 100.00% and 98.75%, respectively. Single, double, triple and quadruple anti-heart failure drugs accounted for 5.98%, 23.08%, 29.06% and 41.88%, respectively. Conclusion: There is still a certain gap between clinical practice and guideline in the utilization of the GDMT-realted medications in patients with chronic HFrEF in our hospital. The usage rate of BB was low, and the dosage of ARNI/ACEI/ARB and BB were seriously insufficient, while MRA was overused. The standardization of GDMT medication needs further improvement.

  Key words: Heart failure with reduced ejection fraction; Guideline-directed medical therapy; Drug evaluation

  提交时间：2025-07-29

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• 序号	提交日期	编号	操作
  1	2025-07-19	10.12201/bmr.202507.00076V1	下载

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