2011～2014年天津地区三级医院氯吡格雷应用分析

The tertiary hospitals of tianjin region clopidogrel application analysis in 2011～2014

目的：通过对天津地区三级医院门诊用药调查，分析氯吡格雷的临床应用现状，为临床合理用药提供参考。方法：通过《医院处方分析合作项目》收集天津地区三级医院2011～2014年门诊处方．提取含氯吡格霄的处方，根据相关信息进行统计分析。结果：在所有调查的门诊处方中，含氯呲格雷的处方共67397张，处方中男性患者多于女性．年龄主要集中在50－79岁．且多数患有高血压、冠状动脉粥样硬化性心脏病、偏瘫、高脂血症、脑梗塞等疾病。用法为每次75mg／d（79．09％）、50mg／d（19．52％）或25mg／d（0．99％）。其他用法用量出现较少。结论：使用氯吡格雷的患者多为患高血压和冠心病的老年男性．部分临床医师在使用氯吡格雷时，医嘱用法用量未遵循说明书和相关临床应用指南．应用25mg／d的维持剂量存在不合理性。部分门诊处方出现无诊断用药。建议加强医师对用药知识的了解和临床药师用药指导和监督，规范门诊处方．以提高临床合理用药水平。

Objective： Through the outpatient drug investigation of the tertiary hospitals of tianjin region, the status quo of clinical application of clopidogre was analyzed, to provide reference for clinical rational drug use, Method： According to the relevant pharmacy data, originating from ＂Hospital prescription analysis of cooperation projects＂ in Tianjin outpatient prescriptions in 2011- 2014, prescription containing clopidogrel was extracted, according to the relevant information for statistical analysis. Result： All the survey of outpatient prescriptions, including the prescriptions of clopidogrel were 67397, and prescriptions of men more than women, mainly concentrated in 50~79 years old, and most people with high blood pressure, coronary atherosclerosis, heart disease, hemiplegia, hyperlipidemia, cerebral infarction and other diseases. Usage for each is 75mg/d（79.09%）, 50mg/d（19.52%） or 25mg/d（0.99%）. Other dosage appears less. Conclusion： Most of the use of clopidogrel in patients with hypertension and coronary heart disease are for older men. Part of clinicians does not follow the instructions dosage and clinical application guides. Application of 25mg/d maintenance dose for the existence is not irrational. Part outpatient prescription drugs appear no diagnosis guidance. It proposed to strengthen the understanding of medication knowledge of physicians and clinical pharmacists＇ medication guide and supervise, regulate outpatient prescriptions to improve the level of rational drug use.