北京地区70家基层医疗机构2010～2012年心脏治疗药使用情况分析

Analysis on the usage of cardiac therapy drugs in 70 primary health care institutions in Beijing from 2010 to 2012

目的研究北京地区70家基层医疗机构2010～2012年心脏治疗药使用情况。方法对参加"北京基层医疗机构药物利用评价及用药合理性监测研究"的70家社区医院2010～2012年按月上报的心脏治疗药的使用情况进行统计。心脏治疗药按照解剖学治疗学化学(ATC)的分类系统进行分类。统计内容包括医院基本归属地和分级、药品名称、生产厂家、金额、使用时间、使用数量。结果北京地区70家基层医疗机构2010～2012年心脏治疗药使用量前3位的是单硝酸异山梨酯(35.63%)、前列地尔(27.67%)、丹参酮ⅡA(19.73%);药品销量前3位的厂商是鲁南制药集团(32.48%)、上海第一生化药业有限公司(19.66%)、北京泰德制药有限公司(14.80%)。冬季(11～1月)用药数量为(76.00±9.87)万盒、金额为(2562.01±479.43)万元;夏季(5～7月)用药数量为(48.23±2.08)万盒,金额为(1807.71±87.77)万元;不同季节用药数量差异有统计学意义(t=4.76,P=0.021),金额差异无统计学意义(t=2.68,P=0.058)。一级医院心脏治疗药使用数量为(2.83±4.56)万盒,金额为(113.94±190.47)万元;二级医院药使用数量为(23.75±15.18)万盒,金额为(907.55±604.52)万元;差异有统计学意义(t数量=5.44,P<0.001,t金额=5.18,P<0.01)。郊区医院的用药数量为(10.46±17.10)万盒,金额为(408.96±662.06)万元;市区医院用药数量为(5.75±6.87)万盒,金额为(221.49±275.45)万元;差异无统计学意义(t数量=1.37,P=0.091;t金额=1.40,P=0.086)。结论北京基层医疗机构心脏治疗药品以单硝酸异山梨酯、前列地尔、丹参酮ⅡA占主导地位,心血管系统疾病发病率逐年上升,药品使用以国产药占优势,冬春季节用药数量明显高于其他季节,二级医院的平均使用数量和金额要高于一级医院,郊区医院的用药数量和金额高于市区医院。

Objective To investigate the usage of cardiac therapy drugs in 70 primary heahh care institutions in Bei- jing from 2010 to 2012. Methods Statistics of the usage of cardiac therapy drugs in 70 primary health care institutions which participated in the issue ＂drug usage evaluation and rational moniting and researching in primary health care in- stitutions in Beijing＂ form 2010 to 2012 were operated. Classification of cardiac therapy drugs were according to ATC. Statistics included location and grade of hospitals and name, manufacturer, amount, using month, number of drugs. Results The frequently used 3 kinds of cardiac therapy drugs were Isosorbide Mononitrate （35.63%）, Alprostadil （27.67%） and Tanshinone 11 A （19.73%）. The dominant medicine manufacturers were Lunan Pharmaceutical Group （32.48%）, Shanghai No.1 Biochemical Pharmaceutical Co., Ltd. （19.66%） and Beijing Tide Pharmaceutical Co., Ltd （14.80%）. （76.00±9.87） ten thousand boxes and （2562.01±479.43） ten million Yuan of drugs were used in winter （11-1 month）, whereas （48.23±2.08） ten thousand boxes and （1807.71±87.77） ten million Yuan were used in summer （5-7 month）, the difference in number had statistically significant （t = 4.76,P = 0.021）, but the difference in amount had no statistically significant （t = 2.68,P = 0.058）. （2.83±4.56） ten thousand boxes and （113.94±190.47） ten thousand Yuan of drugs were used in grade I hospitals, whereas （23.75±15.18） ten thousand boxes and （907.55±604.52） ten million Yuan were used in grade Ⅱ hospitals, the differences were statistically significant （tNumber = 5.44, P 〈 0.001; tAmourt= 5.18, P 〈 0.001）. （10.46±17.10） ten thousand boxes and （408.96±662.06） ten thousand Yuan of drugs were used in suburbs hospitals, while （5.75±6.87） ten thousand boxes and （221.49±275.45） ten million Yuan were used in urban hospitals, the differences were not statistically significant （tNumber= 1.73, P = 0.091; tAmount = 1.40, P = 0.086）. Conclusion The most frequently used drugs are Isosorbide Mononitrate, Alprostadil and Tanshinone Ⅱ A in primary health care institutions of Beijin for cardiac therapy. Cardiovascular disease incidence increased year by year. Drugs manufactured by domestic enterprises occupy the market. The amounts of drugs used in winter, in grade Ⅱ hospitals and in suburb hospitals are greater than those in summer, grade I hospitals and urban hospitals.