口服免疫抑制剂三年使用情况调查

Survey of usage of oral immune inhibitors in 2010--2012

目的分析第三军医大学第二附属医院2010～2012年口服免疫抑制剂的使用情况,为合理使用免疫抑制剂,降低医药成本提供参考。方法从第三军医大学第二附属医院计算机HIS系统中调取2010～2012年各类口服免疫抑制剂的使用数据,计算各类药品的用药频率（DDDs）,日均费用（DDDc）及联合用药数据,综合分析临床用药情况。结果抑制嘌呤合成类＂吗替麦考酚酯＂和钙调神经素抑制剂＂他克莫司＂的使用最为广泛,平均占35.33%和36.03%,但日均费用排名却相对靠后;免疫抑制剂方案的选择中,二联疗法（吗替麦考酚酯＋他可莫司/环抱素）及三联疗法（吗替麦考酚酯＋他可莫司/环抱素＋咪唑立宾/西罗莫司）的使用比例分别占20.3%和79.7%,三联疗法的使用比例远高于二联疗法。结论该院口服免疫抑制剂的使用基本合理,但在进一步优化联合用药方案,合理控制药品费用方面仍需加大监管力度。

Objective To survey the usage of oral immunosuppressive drugs in a hospital from 2010 to 2012 in Chongqing city and provide reference for reasonable utilization of immunosuppressive drugs.Methods The clinical usage various oral immunosuppressans in Chongqing from 2010 to 2012 was surveyed by extracting HIS data,and calculating DDDs,DDDc and combination data.Results ＂Mycophenolate mofetil＂ and calcineurin inhibitors ＂tacrolimus＂ were most widely used account for 35.33%and 36.03%respectively,but DDDc ranked behind.In addition,the usage of duplex therapy（mycophenolate mofetil ＋ tacrolimus or cyclosporine） and triple therapy（mycophenolate mofetil ＋ tacrolimus or cyclosporine ＋mizoribine / sirolimus） accounted for 20.3%and 79.7%in the choice of immunosuppressive drugs,showing that the proportion of using triple therapy was much higher than duplex therapy.Conclusion The usage of the oral immunosuppressive drugs is reasonable,but it is essential for promoting combination therapy and control medical cost.