南京地区34家医院2012-2014年呼吸系统吸入剂使用分析

Analysis of the Utilization of Respiratory Inhalants in 34 Hospitals from Nanjing Area during 2012-2014

目的：为呼吸系统吸入剂的合理使用提供参考。方法：采用SPSS 13.0软件分析南京地区34家医院2012-2014年呼吸系统吸入剂的用药频度（DDDs）、销售金额、日均费用（DDC）和医保与自费金额等数据。结果：南京地区34家医院2012-2014年呼吸系统吸入剂共涉及4种类型、5种剂型、12种通用名和38种商品名（规格）。呼吸系统吸入剂总DDDs和总销售金额分别从2012年的10 827.46×10^3和7 100.65万元增至2014年的14 627.25×10^3和9 913.71万元,但增长趋势均无统计学意义（P〉0.05）。4种类型呼吸系统吸入剂DDDs排名依次为抗胆碱能药物、复合制剂、糖皮质激素和β_2受体激动药,各类型DDDs均逐年增加,但仅抗胆碱能药物DDDs增加趋势有统计学意义（P〈0.01）;销售金额排名依次为糖皮质激素、复合制剂、胆碱能药物和β_2受体激动药,各类型销售金额均逐年增加,但增加趋势均无统计学意义（P〉0.05）。5种剂型呼吸系统吸入剂DDDs排名依次为气雾剂、粉雾剂、雾化溶液、鼻喷剂和肺部输药器,气雾剂和粉雾剂DDDs均逐年增加,趋势有统计学意义（P〈0.05）;2012-2013年销售金额居首位的均为粉雾剂,2014年为雾化溶液,而3年总销售金额位居首位的仍为粉雾剂。12种通用名吸入剂DDDs排名前4位的药品是溴化异丙基阿托品、沙美特罗替卡松、沙丁胺醇和布地奈德,其3年总DDDs构成比分别为40.16%、16.71%、13.51%和13.39%,构成比合计〉80%;销售金额排名前3位的药品是布地奈德、沙美特罗替卡松和布地奈德福莫特罗,其3年总销售金额构成比分别占39.59%、20.81%和12.50%,且构成比合计〉70%。沙丁胺醇DDC最低。38种商品名（规格）吸入剂中,医保品种和医保金额分别占92.11%和95.02%。普米克令舒雾化混悬液医保金额居首位,信必可都保（160μg）自费金额居首位,都属乙类医保药品。结论：南京34家医院2012-2014年呼吸系统吸入剂总体使用基本合理。

OBJECTIVE： To provide reference for rational use of respiratory inhalants. METHODS： The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs, consumption sum, DDC, health insurance and self-paying cost and so on. RESULTS： Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms, 12 kinds of general name and 38 kinds of trade name （specification） in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46× 10^3 and 71,006, 500 yuan in 2012 and 14 627.25×10^3 and 99,137,100 yuan in 2014, there was no statistical significance （P〉0.05）. 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents, compound preparations, glucocorticoid and 132 receptor ago- nists; DDDs of each type increased year by year, but only that of anticholinergic agents had statistical significance （P〈 0.01）. Con- sumption sum were glucocorticoid, compound preparations, anticholinergic agents and 132 receptor agonists; consumption sum of each type increased year by year, but there was no statistical significance （P〉0.05）. 5 kinds of inhalants in the list of DDDs were aerosol preparation, power aerosols, atomizing solution, nasal spray and clickhaler. DDDs of aerosol preparation and power aero- sols increased year by year, with statistical significance （P〈0.05）. Top one in the list of consumption sum was power aerosols dur- ing 2012-2013 and atomizing solution in 2014; power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants, top 4 inhalants in the list of DDDs were ipratropium bromide, salmeterol and flutica- sone, albuterol and budesonide, and the constituent ratio of their total DDDs in 3 years were 40.16%, 16.71%, 13.51% and 13.39%, respectively; the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of con-sumption sum were budesonide, salmeterol and fluticasone, budesonide and formoterol, and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%, 20.81% and 12.50%, respectively; the sum of constituent ratio was more than 70%. DDC of salbutamol was the lowest. Among 38 kinds of trade name （specification） inhalants, the type and cost of health insurance accounted for 92.11% and 95.02%.Pulmicort atomization suspension and Symbicort Turbuhaler （160μg） took up the first place in the list of health insurance cost and self-paying cost respectively, and they were B directory of health insurance. CONCLUSIONS： The utilization of respiratory inhal- ants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.