【摘要】 目的 在老年心力衰竭(Heart failure, HF)患者中评估潜在不适当用药(Potentially inappropriate medication, PIM)情况及PIM数量与生活质量(Quality of life, QOL)、抑郁症之间的相关性。方法 在绵阳市中心医院心血管内科提取1 026例左心室射血分数<50%的老年HF患者，收集患者的一般资料、临床情况和药物治疗的数据，同时采用明尼苏达心功能不全生命质量量表(Minnesota Living with Heart Failure Questionnaire, MLHFQ)评估生活质量情况，采用患者健康问卷-9(Patient Health Questionnaire 9,PHQ-9)评估抑郁情况，采用2019版Beers标准评估患者的PIM情况。应用Pearson相关系数法分析MLHFQ、PHQ-9与PIM数量或药物数量之间的相关性。结果 患者共服用了8 319种药物，平均服用(8.11±3.29)种药物，有80.02%的患者至少服用了1种PIM。利尿剂(57.99%)和质子泵抑制剂(42.98%)是最常用的PIM。PIM的数量与药物数量、MLHFQ、PHQ-9评分呈中度相关。线性回归显示，药物数量、年龄≥85岁、肾功能不全和纽约心功能分级(New York Heart Association, NYHA)Ⅲ的HF与增加的PIM相关。结论 在老年HF患者中发现用药数量、年龄增加和肾功能不全、心功能恶化会提高PIM的占比，从而影响患者的生活质量、抑郁症水平，因此需要临床多学科团队来控制HF患者的PIM应用。更多还原

【Abstract】 Objective To assess the situation of potentially inappropriate medication(PIM), and the association between PIM quantity and quality of life(QOL) and depression in elderly patients with heart failure(HF).Methods A total of 1 026 elderly HF patients with left ventricular ejection fraction <50% were chosen in the Department of Cardiovascular Medicine of Mianyang Central Hospital, and their general information, clinical conditions and drug application data were collected; at the same time the Minnesota Living with Heart Failure Questionnaire(MLHFQ) was used to assess quality of life and Patient Health Questionnaire 9(PHQ-9) was used to assess depression; each patient′s PIM drug profile was assessed using the 2019 Beers criteria.Correlation analysis was performed using the Pearson correlation coefficient method between MLHFQ,PHQ-9 and the number of PIM or drugs.Results The patients took a total of 8 319 drugs, with an average of(8.11±3.29) drugs, and 80.02% of the patients took at least one PIM.Diuretics(57.99%) and proton pump inhibitors(42.98%) were the most commonly used PIMs.The number of PIMs was moderately correlated with the number of drugs, MLHFQ and PHQ-9 scores.Linear regression showed that number of drugs, age ≥85 years, renal insufficiency, and HF of NYHA(New York Heart Association) III were associated with increased PIM.Conclusion In elderly HF patients, it is found that the increase in number of drugs and age, renal insufficiency and worsening of cardiac function will increase the proportion of PIM,thereby affecting the quality of life and depression level of patients, thus a clinical multidisciplinary team is needed to control the application of PIM in patients with HF.更多还原