住院患者核苷(酸)类似物抗病毒药物利用及影响因素分析

Drug utilization and its influential factors in hospitalized patients with nucleoside or nucleotide analogues of antiviral drugs

目的探讨本院感染科慢性乙型肝炎病毒(HBV)感染患者核苷(酸)类似物抗病毒药物的使用影响因素和用药合理性。方法将2013年1月至2014年8月在本院感染科住院的138例慢性HBV感染患者分为非肝硬化组(n=72)和肝硬化组(n=66),对2组患者住院期间核苷(酸)类似物抗病毒药物的使用情况进行统计分析,并收集影响因素数据进行单因素和多因素Logistic回归分析。结果非肝硬化组使用最多的是恩替卡韦(50.0%),肝硬化组使用最多的是阿德福韦酯(27.3%);职业、胆红素、年龄、ALT、AST、HBV DNA是非肝硬化组使用的影响因素。ALT、AST、ALT/AST、胆红素、白球比是肝硬化组使用的影响因素。结论慢性HBV感染患者核苷(酸)类似物抗病毒药物的使用受多种影响因素共同作用,选用哪1种或2种联用要综合考虑患者的临床情况和个人意愿;本院感染科核苷(酸)类似物抗病毒药物用药基本合理,但也存在少数不合理的用药行为。

Objective To determine the effect of nucleoside or nucleotide analogues of antiviral drugs on HBVinfected patients and drug use rationality. Methods Totally 138 patients with HBV-infected patients in our hospital from January 2013 to August 2014 were divided into a non-cirrhosis group（n = 72） and a cirrhosis group（n = 66）. The utilization of nucleoside or nucleotide analogues of antiviral drugs in both groups was analyzed statistically. The single factor test and multi factor test Logistic regression analysis were used to analyze the data. Results The use of entecavir in non-cirrhosis patients was highest, while the use of adefovir dipivoxil in cirrhosis patients was highest. Logistic regression analysis showed that occupation, bilirubin, age, ALT, AST and HBV DNA were the major influence factors for the non-cirrhosis group, while ALT, AST, ALT/AST, bilirubin and white ball ratio were the major influence factors for the cirrhosis group. Conclusion The effects of nucleoside or nucleotide analogues analogues of antiviral drugs on HBV-infected patients are influenced by many factors. The choice of one or two depends on the clinical situation and personal willingness. The use of drugs is rational in our hospital, with a few unreasonable drug use behaviors.