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目的 分析老年慢性心力衰竭患者出院带药中抗胆碱能药物使用情况及其相关危险因素。方法 收集2020年1月1日至2023年12月31日北京大学人民医院心血管内科住院的老年慢性心力衰竭患者240例，根据抗胆碱能认知负荷量表(anticholinergic cognitive burden, ACB)评分分为抗胆碱能组223例(ACB评分≥1分)和非抗胆碱能组17例(ACB评分0分)。应用ACB评分对老年慢性心力衰竭患者抗胆碱能负担进行量化，采用logistic回归分析抗胆碱能负担与各相关因素的关系。结果 抗胆碱能组年龄明显低于非抗胆碱能组[(75.17±7.21)岁vs(79.12±8.75)岁，P<0.05],出院带药种类明显高于非抗胆碱能组[8(6,10)种vs 5(4,7)种，P<0.01]。logistic回归分析显示，出院带药种类是老年慢性心力衰竭患者抗胆碱能负担增加的独立危险因素(OR=1.575,95%CI:1.249～1.986,P=0.001)。结论 老年慢性心力衰竭患者使用抗胆碱能药物比例较高。临床上应重点关注多重用药，以降低抗胆碱能药物所致不良事件发生率。
Abstract：Objective To analyze the use of anticholinergic medications at discharge among elderly patients with chronic heart failure(CHF) and its associated risk factors.Methods Clinical data of 240 elderly CHF patients admitted in our Department of Cardiovascular Diseases between January 1,2020,and December 31,2023 were colloected.Based on ACB score, they were divided into an anticholinergic group(ACB score≥1,223 cases) and a non-anticholinergic group(ACB score of 0,17 cases).Using the ACB score, the anticholinergic burden was quantified, and the relationship between anticholinergic burden and various related factors was analyzed using logistic regression.Results The anticholinergic group had significantly younger age [(75.17±7.21)years vs(79.12±8.75)years, P<0.05],and larger number of discharge medications [8(6,10) vs 5(4,7),P<0.01] when compared with the non-anticholinergic group.Logistic regression analysis showed that the number of discharge medications was an independent risk factor for increased anticholinergic burden in the elderly CHF patients(OR=1.575,95%CI:1.249-1.986,P=0.001).Conclusion The proportion of elderly CHF patients using anticholinergic medications is relatively high.Clinically, special attention should be given to polypharmacy to reduce the incidence of adverse events caused by anticholinergic drugs.
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基本信息:
中图分类号:R541.6
引用信息:
[1]郑方芳,靳晶晶,任艳丽,等.老年慢性心力衰竭患者出院带药抗胆碱能药物评价[J].中华老年心脑血管病杂志,2025,27(03):294-297.
2025-03-13
2025-03-13