上海莘庄社区2007—2011年抗高血压药物的应用情况分析

Analysis of Antihypertensive Drug Use in Xinzhuang Community Health Service Center in Shanghai between 2007 and 2011

目的了解社区基层抗高血压药物应用状况,为制定社区用药规范提供临床依据。方法根据莘庄社区卫生服务中心信息库的资料,对2007—2011年门诊高血压患者的用药记录进行分析。结果 (1)单药治疗比例从2007年的91.7%减少到2011年的74.7%,联合用药的比例从2007年的8.3%增加到2011年的25.3%,3种及以上的联合用药2011年仅占3.3%;(2)2007年最常用的制剂依次为传统的复方制剂、钙离子拮抗剂(CCB)和血管紧张素Ⅱ受体拮抗剂(ARB),分别占44.7%、36.3%和5.8%,到2011年最常用的制剂依次为CCB、传统的复方制剂和ARB,分别占49.1%、24.0%和16.7%;(3)以硝苯地平片为例,5年中应用长效制剂增加了20.9%,短效的硝苯地平减少了29.3%;(4)国产的CCB和ARB制剂使用人数不断增加,2011年分别占95.7%和79.4%。结论社区的抗高血压治疗不足的现象较为明显,单药的应用比例较高;合理选药的水平在提高,CCB和ARB应用增多,传统的复方制剂应用减少;选择长效制剂理念逐渐增强;联合用药措施逐渐得到重视,应用比例在增加;国产制剂在社区高血压治疗中占主导地位。

Objective To analyze the use of antihypertensive drug in community health service centers in the past, aiming at laying foundations for further standardization of antihypertensive drug use in the future. Methods Records of antihypertensive drug use in Xinzhuang Community Health Service Center in Shanghai between 2007 and 2011 were retrieved from the Center＇s Electronic Health Records （EHR） system and analyzed. Results The percentage of monotherapy was decreased from 91. 7% in 2007 to 74.7% in 2011. The percentage of combination therapies was increased from 8.3% in 2007 to 25.3% in 2011. Prescribing more than 3 drugs in combination accounted for 3. 3% in 2011. In 2007, the most frequently described antihypertensive medications were the conventional single - pH compounded drugs （44.7%）, followed by calcium channel blockers （ CCB, 36. 3% ）, and angiotensin II receptor blocker （ARB, 5. 8%） . In 2011, CCB （49. 1 %） became the most frequently described drug, which was followed by the conventional compounded drugs （24.0%） and ARB （16. 7%） . Over time, the use of long - term preparations was increased. For instance, the use of controlled and sustained release tablets of nifedipine was increased by 20.9%, while the use of its short term was decreased by 29.3% during the 5 - year period （2007-2011） . The market share of domestically made drugs increased significantly. By 2011, 95.7% of CCB and 79.4% of ARB used were made domestically in China. Conclnsion Significant changes occurred in hypertensive therapy in Xinzhuang Community Health Service Center in Shanghai between 2007 and 2011, including increases in the monotherapy to combination therapy ratio, in the use of compounded hypertensive drugs （e. g. CCB and ARB）, in the use of long - lasting formulas, and in the use of domestic drugs. All these changes should be considered as foundations for future standardization of antihypertensive drug use in community health service centers in Shanghai.