40家军队医院治疗药物监测情况调查

Survey on the current situation of therapeutic drug monitoring in 40 military hospitals

目的:调查和了解军队医院开展治疗药物监测(therapeutic drug monitoring,TDM)的情况。方法:利用互联网技术,借助移动网络平台设计、传送、提交、回收问卷并进行统计分析。结果:回收有效问卷40份,涉及总医院14份、军医大学附属医院7份、中心医院19份,分布于中国大陆21个省、直辖市、自治区。80%的军队医院开展了药物浓度检测,以免疫抑制剂、抗感染药物、抗癫药物等为主。单品种检测量较多的是他克莫司、吗替麦考酚酸、雷帕霉素、环孢素、丙戊酸钠和万古霉素。60%的军队医院开展了药物基因检测,检测量较多的是CYP2C19、CYP2C9、VKORC1、CYP3A5、CYP2D6、HLA-B*1502、MTHFR及UGT等相关基因。22.5%的军队医院开展了药物代谢检测,其中一半以上于2010年以后才开展。结论:本次问卷调查客观反映了当前军队医院TDM工作的开展现状,为今后更好地开展TDM工作、明确学科发展方向以及制定政策规范提供了有意义的参考依据。

Objective : To investigate the current situation of therapeutic drug monitoring (TDM) performed by military hospitals in China.Methods : Questionnaire forms were designed,issued,submitted and retrieved by Internet network technique and mobile network platform,and the retrieved copies of questionnaire forms were analyzed.Results : A total of 40 valid questionnaires were recovered,including 14 from the general hospitals, 7 from the affiliated hospitals of military medical universities and 19 from central hospitals, covering 21 provinces,municipalities and autonomous regions of China's Mainland.80% of the military hospitals performed drug concentration detection, with immunosuppressants, anti-infective and antiepileptic drugs as the main drugs.Tacrolimus, mycophenolic acid, rapamycin, cyclosporine, sodium valproate and vancomycin were the most frequently detected drugs.60% of the military hospitals performed drug gene detection, in which CYP2C19, CYP2C9, VKORC1, CYP3A5, CYP2D6, HLA-B*1502, MTHFR and UGT gene polymorphism sites were predominant test genes.22.5% of the military hospitals carried out drug metabolism detection, and more than half of them were carried out after 2010.Conclusion : The questionnaire survey objectively reflected the current situation of TDM in military hospitals, which could provide the valuable reference for further improvement of TDM, better orientation in the development of related disciplines and development of related policies and regulations in the future.