20家儿童医疗机构常见17种治疗药物监测情况分析

Analysis of Current Situation of Therapeutic Drug Monitoring of 17 Commonly Used Drugs in 20 Pediatric Hospitals of China

目的:调查了解国内儿童医疗机构治疗药物监测(TDM)开展情况。方法:对全国20个省市自治区的20家儿童三级专科医院(妇幼保健院)TDM情况开展问卷调研,对调查数据进行统计和分析并提出建议。结果:共发放问卷23份,回收有效问卷22份,问卷回收率为95.7%,纳入研究问卷20份,有效率90.9%。参与调研的医院全部开展丙戊酸的TDM,但20家医院监测5种及以上药物的仅占50.0%,检测方法多为高效液相色谱(HPLC)法或酶放大免疫分析(EMIT)法;多数医院目前只能提供监测值,不能做到通过专业解读指导临床个体化治疗;部分医院对TDM的质量控制局限于内部质量控制。结论:调查结果较好地反映了当前国内儿科医院TDM的开展现状。TDM在开展品种数量、检测方法、质量控制方法、结果解读等方面还有待进一步提高。

Objective:To investigate the development of therapeutic drug monitoring in pediatric hospitals of China.Methods:Questionnaire survey was conducted on the TDM situation of 20 pediatric tertiary specialized hospitals(maternal and child health care hospitals)in 20 provinces,municipalities and autonomous regions across the country.Statistics and analysis were conducted on the survey data to make recommendations.Results:A total of 23 questionnaires were distributed and 22 valid questionnaires were collected.The recovery rate of the questionnaire was 95.7%;And 20 questionnaires were included for further study,with an effective rate of 90.9%.The hospitals participating in the survey all carried out TDM of valproic acid,but only 50.0%of the them monitored 5 or more drugs;The detection methods were HPLC and EMIT.Currently,most hospitals only provide monitoring values,which cannot guide clinical individualized treatment.The quality control of TDM in some hospitals is limited to internal quality control.Conclusion:The survey results reflect the current status of TDM development in pediatric hospitals in China,and it is in need to be further improved in the fields of the number of varieties,detection methods,quality control methods,and interpretation of results.