2026 年第 2 期 第 21 卷

心血管门诊心力衰竭患者含有可能加重心力衰竭药物的长处方开具情况及影响因素分析

Analysis of prescription status and influencing factors of long-term prescriptions containing may heart failure-exacerbating medications in outpatients with heart failure in cardiology department

作者：白颖1王建旗2肖洁2周震3王家伟1

英文作者：Bai Ying1 Wang Jianqi2 Xiao Jie2 Zhou Zhen3 Wang Jiawei1

单位：1首都医科大学附属北京同仁医院药学部，北京100730；2首都医科大学附属北京同仁医院心血管中心，北京100730；3首都医科大学生物医学工程学院，北京100069

英文单位：1Department of Pharmacy Beijing Tongren Hospital Capital Medical University Beijing 100730 China; 2Cardiovascular Center Beijing Tongren Hospital Capital Medical University Beijing 100730 China; 3School of Biomedical Engineering Capital Medical University Beijing 100069 China

关键词：心力衰竭；多重用药；影响因素

英文关键词：Heartfailure;Polypharmacy;Influencingfactors

• 摘要：

• 目的 探讨心血管门诊心力衰竭患者含有可能加重心力衰竭药物（HFEM）的长处方开具情况并分析其影响因素。方法 收集2022年1—12月首都医科大学附属北京同仁医院心血管门诊1 559例心力衰竭患者的处方资料进行回顾性分析。根据2016年美国心脏协会发布的HFEM目录筛选包含HFEM的处方。根据处方是否存在HFEM分为HFEM组和非HFEM组，比较2组患者临床特征、合并疾病数量、主要共病、用药数量、处方医师职称，分析开具含有HFEM处方的影响因素。结果 本研究共纳入1 559例长处方诊断中包括心力衰竭或心功能不全患者，其中168例患者使用HFEM（HFEM组）、占10.8%。HFEM组合并疾病数量多于非HFEM组，共病高血压病、糖尿病、焦虑抑郁状态、用药数量≥5种比例高于非HFEM组，共病心律失常比例低于非HFEM组，差异均有统计学意义（均P<0.05）。多因素Logistic回归分析结果提示合并疾病数量、共病糖尿病、共病焦虑抑郁状态、用药数量是开具含有HFEM处方的独立影响因素（比值比=0.848、6.343、5.502、1.372，均P<0.05）。结论 10.8%的心血管门诊心力衰竭患者长处方中存在HFEM。合并疾病数量、合并糖尿病、焦虑抑郁疾病和用药数量是开具含有HFEM处方的独立影响因素。

• Objective To investigate the prescription status of long-term prescriptions containing may heart failure-exacerbating medications (HFEM) in outpatients with heart failure in cardiology department and analyze its influencing factors. Methods A retrospective analysis was conducted on the prescription data of 1 559 outpatients with heart failure who visited the cardiology department of Beijing Tongren Hospital, Capital Medical University from January to December 2022. Prescriptions containing HFEM were screened according to the HFEM catalog released by the American Heart Association in 2016. The patients were divided into the HFEM group and non-HFEM group according to the presence or absence of HFEM in the prescriptions. The clinical characteristics, number of complicated diseases, main comorbidities, number of medications used and professional titles of prescribing physicians were compared between the two groups, and the influencing factors for prescribing HFEM-containing prescriptions were analyzed. Results A total of 1 559 patients with heart failure or cardiac insufficiency in the diagnosis of long-term prescriptions were included in this study, among whom 168 patients (10.8%) were prescribed HFEM (HFEM group). The number of complicated diseases in the HFEM group was higher than that in the non-HFEM group. The proportions of comorbid hypertension, diabetes mellitus, anxiety-depressive state and medication use ≥5 kinds in the HFEM group were higher than those in the non-HFEM group, while the proportion of comorbid arrhythmia was lower than that in the non-HFEM group (all P<0.05). Multivariate Logistic regression analysis showed that the number of complicated diseases, comorbid diabetes mellitus, comorbid anxiety-depressive state and number of medications used were independent influencing factors for prescribing HFEM-containing prescriptions (odds ratio=0.848, 6.343, 5.502, 1.372)(all P<0.05). Conclusions HFEM are present in 10.8% of long-term prescriptions for outpatients with heart failure in cardiology department. The number of complicated diseases, comorbid diabetes mellitus, anxiety-depressive state and number of medications used are independent influencing factors for prescribing HFEM-containing prescriptions.