全国8市712192例高血压患者口服钙通道阻滞剂的使用分析

Calcium channel blockers utilization analysis of 712192 hypertensive patients of 8 cities in China

目的:分析2017年全国8个城市使用钙通道阻滞剂(calcium channel blockers,CCBs)高血压患者的特征和药品使用情况,为临床合理用药提供参考。方法:基于2017年《医院处方分析项目》随机抽取的处方数据,采用世界卫生组织推荐的药物利用分析方法,对CCBs类降血压药物使用情况进行分析。结果:共抽取8个城市105家医院的712 192例高血压患者口服CCBs类降血压药物的处方。北京地区患者最多,占25.28%。平均年龄(65.60±14.07)岁。患者主要于门诊购药,占86.12%。处方科室主要为内科,占78.62%。可报销药品占比79.75%。7.65%的高血压患者合并肾病。处方数量和处方金额最大的3种药品是一致的,依次为氨氯地平、硝苯地平和左旋氨氯地平;其处方日剂量/限定日剂量(prescribed daily dose/defined daily dose,PDD/DDD)值均>1:氨氯地平(1.27±0.53)、硝苯地平(1.27±0.53)和左旋氨氯地平(1.64±0.91);合并肾病患者的PDD/DDD值高于患者平均水平:氨氣地平(1.53 vs.1.25),硝苯地平(1.64 vs.1.23),左旋氨氣地平(1.85 vs.1.63)。结论:氨氣地平、硝苯地平和左旋氨氣地平为临床最常用的3种CCBs,其临床日剂量均高于成人常用日剂量,合并肾病的高血压患者的日剂量更高。

Objective:To analyze the characteristics and drug usage of calcium channel blockers(CCBs) in hypertensive patients from 8 cities of China in 2017,and to provide reference for rational drug use in clinic.Methods:Using randomized data from the "Hospital Prescription Analysis Cooperation Project" and drug utilization methos recommended by WHO,we analyzed the CCBs usage characteristics.Results:A total of 712 192 prescriptions of hypertensive patients using CCBs from 105 hospitals in 8 cities were selected.Most of the patients were from Beijing city,accounting for25.28%.The average age was(65.60±14.07) years old.And 86.12% of the patients were outpatients,78.62% of the patients were from internal medicine department,79.75% of the medicines can be reimbursed,7.65% of the hypertensive patients had kidney complications.Prescription quantity and prescription amount of the top 3 drugs are consistent,followed by amlodipine,nifedipine and levoamlodipine in order.Its prescribed daily dose/defined daily dose(PDD/DDD) values were> 1.The PDD/DDD value were(1.27±0.53) for amlodipine,(1.27±0.53) for nifedipine and(1.64±0.91) for levamlodipine,respectively.The PDD/DDD value for patients with kidney complications higher than the average level:(1.53 vs.1.25) for amlodipine,(1.64 vs.1.23) for nifedipine,and(1.85 vs.1.63) for levamlodipine.Conclusion:Amlodipine,nifedipine,and levamlodipine were the most commonly used CCBs in clinic.The daily clinical dose was higher than that of adults,and the daily dose of hypertension patients with nephropathy was higher.