在慢性心力衰竭治疗中使用和优化β抑制剂的剂量:一种混合方法研究
Sisay Sitotaw Anberbr1, Tilaye Arega Moges2, Abebech Tewabe Gelaye3
1Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. sisaysitotaw21@gmail.com.
BMC cardiovascular disorders
|June 8, 2025
概括
在心力衰竭中使用β-阻塞剂 (BB) 降低射出分数 (HFrEF) 是不理想的,只有10%的患者达到最佳剂量. 改善BB利用需要遵守指导方针和更好的药物获取.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 降低射出率心力衰竭 (HFrEF) 影响全球超过6400万,造成严重的健康负担.
- 埃塞俄比亚是一个资源有限的环境,在管理HFrEF方面面临挑战,特别是在以证据为基础的β抑制剂 (BB) 治疗中.
- 在HFrEF中,BBs的低于最佳的实施和剂量有助于临床结果差.
研究的目的:
- 评估冈达尔大学综合专门医院 (UOG-CSH) 的HFrEF患者的β-阻断剂 (BB) 使用率和最佳剂量模式.
- 确定影响BBs在HFrEF管理中的有效应用和最佳剂量的因素.
- 通过定性见解,探索BB使用和最佳剂量的障碍和促进因素.
主要方法:
- 从2018年9月到2023年8月,对420名成年HFrEF患者 (EF ≤40%) 的回顾性队列研究.
- 通过人口统计,临床特征和药物使用的问卷收集的数据;使用二进制后勤回归分析.
- 遵循2022年AHA和2021年ESC指南;补充了与九名医生进行半结构面试以获得定性数据.
主要成果:
- 只有52.4% (220/420) 的HFrEF患者获得了基于证据的BB,只有10% (22/220) 获得了最佳剂量.
- 与BB使用相关的因素包括年龄较大,缺血性心脏病,心房动,甲状腺功能障碍和更长的HF持续时间.
- 最佳的BB剂量与膜心脏病,多种并发症和更长的HF持续时间有关;障碍包括药物可用性和坚持问题.
结论:
- 对HFrEF的BB利用存在显著的治疗差距,只有10%的患者接受最佳剂量.
- 建议包括加强医疗保健提供者的培训计划,严格遵守临床指南,改善药物可用性.
- 解决BB使用和最佳剂量的障碍对于改善HFrEF患者的治疗结果至关重要.
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