451例真实世界HIV感染患者临床用药规律探析

Analysis of Clinical Medication Laws for 451 Patients with HIV Infection in a Real World

目的分析真实世界人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染患者临床特征及用药规律。方法基于医院信息系统(hospital information system,HIS)真实世界数据,提取2006年1月—2011年12月全国17家三甲医院HIV感染者病历资料,包括患者一般信息、疾病特征及入院期间中西药临床应用情况。结果共收集451例HIV感染者资料,有年龄记录者261例,平均36岁,其中以18~65岁居多[90.4%(236/261)];男女比例为2.8∶1;HIV患者最常入住的科室为传染病科[66.96%(302/451)],其次为呼吸科[8.2%(37/451)]。患者入院方式以门诊为主[79.6%(359/451)],其中以急诊方式入院占20.18%(91/451)。患者多因感染性疾病住院,其中以结核病最多(8.29%),其次为细菌性肺炎(6.44%)。349例有完整用药记录,共使用西药399种,中成药80种。抗微生物药使用频率最高(11.86%),以复方磺胺甲噁唑最多(2.81%)。80种中成药以清热解毒剂最常用(19.27%),其次为解表剂(10.30%)、补益剂(8.97%)、祛痰剂(7.31%)。抗微生物药联合清热解毒剂是最常见的中西药组合。451例HIV感染者经中西药治疗,病情稳定,好转率达51.2%。结论 HIV感染患者中使用频率最高西药是抗微生物类药,使用频率最高中成药为清热类药物。抗微生物药与清热解毒类中成药联合应用在临床上也较为常见。

Objective To analyze clinical features and medication laws of patients with human immunodeficiency virus （HIV） infection. Methods Real world data based on Hospital Information System （HIS） were collected from 17 grade 3 hospitals across China from Jan. 2006 to Dec. 2011. Data of case his- tory in HIV infectors included their general information, features of AIDS, medications of Western drugs and Chinese herbs during hospitalization. Results Data of 451 patients with HIV infection were collected. A total of 261 patients had clear age record. Their age ranged between 18 and 65 [accounting for 90.4% （236/ 261 ） ], with an average age of 36. The ratio of male to female was 2.8： 1. They were hospitalized first at De- partment of Lemology （66.96%）, followed by Department of Respiration （8.2%）. They were admitted to hospital first at clinics （79.6%）, and accepted from Emergency Department （20.18%）. Most of them were admitted to hospital due to infectious diseases. Of them, tuberculosis occupied the top （8.29%）, followed by bacterial pneumonia （6.44%）. Totally 349 patients had complete medication record. A total of 399 kinds of Western drugs and 80 kinds of Chinese patent medicines were used. The frequency of using antimicrobial drugs was the top （11.86%）, and Compound Sulfamethoxazole was mostly used in 120 cases （2.81%）. Of 80 kinds of Chinese patent medicines, heat clearing and detoxifying herbs were most often used（19.27%）, followed by antipyretics （10.30%）, tonics （8.97%）, and expectorant （7.31%）. Antimicrobial drugs combined heat clearing and detoxifying herbs were the most often seen in clinics. The 451 HIV infec- tors had steady condition after treated by Western drugs and Chinese herbs. The improvement rate reached 51.33%. Conclusion Antimicrobial drugs were most often used in HIV patients. Heat clearing and detoxif- ying herbs were most often used in HIV patients. Antimicrobial drugs combined heat clearing and detoxif- ying herbs were most often seen in clinics for HIV patients.