首都医科大学宣武医院2011年老年脑梗死住院患者的药物利用研究

Drug Utilization Analysis of Elderly Inpatients with Cerebral Infarction in Xuanwu Hospital of Capital Medical University in 2011

目的了解首都医科大学宣武医院2011年老年脑梗死治疗中不同治疗药物的使用情况,为老年脑梗死住院患者合理用药提供参考。方法收集该院2011年60岁及以上老年脑梗死住院患者的病历资料。采用ATC编码标化药物通用名和分类。用Microsoft Excel 2007软件描述性分析患者一般情况,计算每种药物的使用例数、限定日剂量(DDDs)和药物利用指数(DUI),分析其合理性。结果共纳入430例患者,纳入患者的平均年龄70.61±7.29岁,平均患病种数5.39种,主要合并疾病为循环系统疾病,占42.45%。共纳入15 656条用药记录,包含243种药物(含不同给药途径),平均用药品种数17.11种。患者药物使用例数百分比前5位分别为银杏叶制剂(注射)、氯吡格雷(口服)、前列地尔(注射)、阿托伐他汀(口服)、桂哌齐特(注射);限定日剂量数(DDDs)前5位分别为银杏叶制剂(注射)、异丙托溴铵(吸入)、前列地尔(注射)、叶酸(口服)、氯吡格雷(口服);DUI前5位分别为维生素B12(注射)、多种维生素(口服)、尼可刹米(注射)、甲泼尼龙(注射)、维生素C(口服)。结论首都医科大学宣武医院老年脑梗死患者主要治疗药物的品种和用法用量选择合理。但DUI高的药物与患者的主要疾病无关,这提示应关注未合理使用的药物临床应用情况,保证药物安全、有效、经济应用。

Objective To evaluate the usage status of drugs in the treatment of senile cerebral infarction in Xuanwu Hospital of Capital Medical University in 2011, and to provide references for rational usage of drugs for inpatients with senile cerebral infarction. Methods Medical records of the elderly（≥60 years old） inpatients with cerebral infarction in Xuanwu Hospital in 2011 were collected. ATC codes were used to standardize names of drug and classifications. Patients＇ general information, number of patients＇ used drugs, Defined Daily Doses（DDDs）, and Drug Utilization Index（DUI）were calculated by using Microsoft Excel 2007 to evaluate the rationality of drugs usage. Results A total of 430 patients were included. The average age was 70.61±7.29 years old. The average types of diseases were 5.39. The major combined disease was circulatory system disease, accounting for 42.45%. A total of 15 656 medication records were included,involving 243 kinds of drugs（including different administration routes）. The average number of used drugs for each patient during the admission was 17.11. The top 5 drugs based on percentage of patients with drug use were Ginkgo Biloba Preparation（injection）, clopidogrel（oral）, prostaglandin E1（injection）, atorvastatin（oral） and cinepazide（injection）.The top 5 drugs of DDDs were Ginkgo Biloba Preparation（injection）, ipratropium bromide（inhalation）, prostaglandin E1（injection）, folic acid（orla）, and clopidogrel（oral）. The top 5 drugs of DUI were vitamin B12（injection）, multi-vitamin（oral）, nikethamide（injection）, methylprednisolone（injection）, and vitamin C（oral）. Conclusion For therapeutic drugs used among the elderly patients with cerebral infarction in Xuanwu Hospital of Capital Medical University, the choice,dosage and administration route of medication are rational. However, the drugs with higher DUI are not related with major diseases, which indicates that we should pay attention to the irrational drug use of clinical application, so as to ensure safety, effectiveness and economy of drug application.