2013—2014年某院肝移植围术期抗排斥药物用药分析

The application of anti-rejection drugs in perioperative period patients of liver transplantationin in a hospital from 2013 to 2014

目的探讨2013—2014年某院肝移植患者术后抗排斥药物的应用情况,了解肝移植患者术后潜在的排斥风险及其各类抗排斥药物在肝移植术中的应用特点,为临床合理应用该类药物提供参考。方法通过医院病历查询系统获得2013—2014年肝移植患者的住院信息,统计各抗排斥药物的用量、金额(零售价)等基本数据,并采用用药频度(DDDs)、限定日费用(DDDc)等指标对该类药物的合理性进行评价。结果 2013—2014年某院肝移植患者术后抗排斥药物应用中钙神经抑制剂类药物和激素类药物所占比例较大,其中钙神经抑制剂他克莫司的用药金额为91 586.88元,占总体金额的36.24%,所占比例最大;激素类药物地塞米松用药金额为30.00元,占总体金额的0.01%,所占比例最小。激素类药物甲泼尼龙琥珀酸钠的DDDs为817,占总体DDDs的45%,所占比例最大;抗体制剂巴利昔单抗的DDDs为4,占总体DDDs的2%,所占比例最小。抗体制剂巴利昔单抗的DDDc为18 675,数目最大;激素类药物地塞米松的DDDc为0.36,数目最小。结论某院肝移植术后患者多存在不同程度的排斥反应,能够根据不同类型的患者、不同程度的排斥反应进行个体化用药,抗排斥类药物应用基本合理。

Objective We analyze the application of anti-rejection drugs in the patients who have operated liver transplant in our hospital from 2013 to 2014,understand the potential risk of rejection after the patients and the application characteristic of anti-rejection drugs in the liver transplant.So it can provide reference for clinical reasonable application of the drugs.Methods Through hospital medical record query system,we obtain the patients with liver transplant information in the hospital and statistics every the amount of anti-rejection drugs,money（retail price）and other basic date.And we use DDDs、DDDc and other evaluation index to evaluate the rationality of the drugs.Results In our hospital liver transplant patients use calcium neural inhibitor and hormone drugs have larger proportion,and the total price of tacrolimus which belong to calcium neural inhibitor drugs is 91586.88 yuan,who is 36.24% of the total amount and it is the largest proportion.The amount of Dexamethasone is 30.00 yuan,which is accounting for 0.01% of the total amount, who is the least proportion.The DDDs of Methylprednisolone Sodium Succinate which is one of hormone drugs is 817,which account 45% of the total DDDs,it is the largest proportion in the DDDs;Antibody preparation Basiliximab＇s DDDs is 4,accontiong for 2% of the total DDDs,and its DDDc is 18675, which is the largest; The DDDc of Dexamethasone is 0.36,that is the minimum number.Conclusion In the hospital liver transplant patients have different degree of rejection,it can accord different type of patients and different degree of rejection to individualized medication.The anti-rejection drugs application is reasonable.