药物利用评价和药物利用评估法评价我院慢性乙型肝炎住院患者保肝药的使用情况

Drug utilization review and drug utilization evaluation for evaluation of usage of hepatoprotective drugs in hospitalized patients with Chronic hepatitis B

目的评价嘉兴市第一医院慢性乙型肝炎住院患者保肝药的用药情况及合理性,为临床合理用药提供参考。方法采用药物利用评价(DUR)和药物利用评估(DUE)法,对该院慢性乙型肝炎住院患者使用保肝药的药物利用指数(DUI)、药物应用情况、治疗过程监测及临床治疗效果进行分析。结果 97例患者共使用保肝药17个品种、21个品规,用药频度前3位的药物分别为多烯磷脂酰胆碱注射液、注射用丁二磺酸腺苷蛋氨酸和注射用复方甘草酸苷。5个品规药物的DUI>1,13个品规的DUI=1,3个品规的DUI<1。一联、二联、三联和四联用药的构成比分别为30.93%(30/97)、46.39%(45/97)、17.53%(17/97)和5.15%(5/97),对应患者肝功能恢复或好转构成比依次为70.00%(21/30)、91.11%(41/45)、82.35%(14/17)和60.00%(3/5)。研究对象均符合病原学分型及临床分期,仅3.09%(3/97)的病例确定了病理学分期。97例患者均有肝功能异常现象,肝功能监测率达100.00%(97/97),93例患者经抗炎保肝等治疗后临床症状得到改善,79例患者肝功能恢复正常。结论联合DUR和DUE法可以更全面地评价慢性乙型肝炎患者的用药情况。该院慢性乙型肝炎住院患者保肝药用药基本合理,二联用药保肝治疗效果最好。

Objective To evaluate the status quo and the rationality of the drug utilization in hospitalized patients with chronic hepatitis B, and provide reference for rational clinical usage of drugs. Methods The methods of drug utilization review（DUR） and drug utilization evaluation（DUE） were used to analyze the drug utilization index（ DUI）, drug applica- tion situation, monitoring of therapeutic process as well as therapeutic outcome of chronic hepatitis B hospitalized in our hospital. Results Total 97 cases of patients with hepatoprotective 17 species and 21 varieties and specifications, DDDs of the top 3 drugs were polyene phosphatidylcholine injection,injection with succinie acid adenosine methionine and injection with compound glyeyrrhizin. The DUIs of 5 kinds of drugs were more than 1 ,DUI = 1 was found in 13 kinds;and DUI 〈 1 was found in 3 kinds. Single, double, triple and quadruple drug constituent ratio were 30.93% （ 30/97）, 46.39% （ 45/ 97 ） , 17.53 % （17/97）and 5.15 % （5/97） , respectively, corresponding to the recovery or improvement of liver function in patients with constituent ratio were 70.00 % （ 21/30 ）, 91.11% （41/45 ）, 82.35 % （ 14/17 ） and 60.00 % （ 3/5 ）. The stud- y subjects were in line with the pathogen and clinical stage, and only 3.09% （ 3/97 ） were confirmed by pathological stage. 97 patients had abnormal liver function, the monitoring rate of liver function was 100.00% （97/97） ,93 patients with the clinical symptoms improved after treatment with anti-inflammatory and hepatoprotective,liver function was restored to nor- real in 79 patients. Conclusion DUR combined with DUE can be more comprehensive evaluation of drug utilization of the patients with chronic hepatitis B. The usage of hepatoprotective drugs in hospitalized patients with chronic hepatitis B in our hospital is basically reasonable, and double therapy may achieve a good therapeutic effect.