296例儿童患者脾多肽注射液应用合理性分析及药物利用研究

Analysis on Rationality and Research on Drug Utilization of Lienal Polypeptide Injection in 296 Children

目的:探讨脾多肽注射液在儿童患者中的应用合理性及药物利用研究。方法:随机抽取2018年6月至2019年5月某儿童医院296例使用脾多肽注射液患儿的病历资料,结合药品说明书、《处方管理办法》、《儿童临床使用免疫调节剂专家共识》以及患儿年龄、体重,建立儿童脾多肽注射液临床合理应用评分标准,包括适应证、药物剂量、溶剂种类、药物浓度、给药频次、联合用药和免疫功能检查等7项指标,对各项指标进行合理性评价,合理记1分,计算各指标合理率及总得分百分率,初步探讨脾多肽注射液在儿童患者中的合理用药评价方法。结果:用药评价结果显示,得分率由高至低依次为药物剂量(100%,296例)、溶剂种类(100%,296例)、给药频次(100%,296例)、适应证(97.97%,290例)、联合用药(95.61%,283例)、药物浓度(79.73%,236例)、免疫功能检查(61.82%,183例)。对患儿的体重进行分组分析,结果显示,单位体质量用药量与体重呈负相关。药物利用分析结果显示,儿童剂量药物利用指数(dose of children drug utilization index,d CDUI)随着体重的增加而降低,且低体重患儿的d CDUI>1,存在过度应用现象;高体重患儿的d CDUI<1,存在用药不足问题。不同体重分组患儿的儿童浓度药物利用指数(concentration of children drug utilization index,c CDUI)均>1,超浓度应用现象严重。结论:应规范脾多肽注射液在儿童患者中的临床应用,促进合理用药。

OBJECTIVE:To probe into the application rationality and drug utilization of lienal polypeptide injection in children.METHODS:Medical history of 296 children treated with lienal polypeptide injection in a certain children’s hospital from Jun.2018 to May 2019 were randomly extracted,combining with the drug instructions,the"Prescription Management Measures",the"Expert Consensus on Clinical Use of Immunomodulators in Children"and the age and weight of children,a scoring standard for the clinical rational application of lienal polypeptide injection on children was established,including 7 indicators of indications,drug dosage,solvent type,drug concentration,administration frequency,drug combination and immune function examination,the rationality of each indicator was evaluated,and 1 point scored when rational,the rational rate and total points were calculated,so as to preliminarily discuss the evaluation method of rational application of lienal polypeptide injection in children.RESULTS:Results of medication evaluation showed that the scoring rates from high to low were respectively drug dosage(100%,296 cases),solvent type(100%,296 cases),administration frequency(100%,296 case),drug indications(97.97%,290 cases),drug combination(95.61%,283 cases),drug concentration(79.73%,236 cases),immune function examination(61.82%,183 cases).Results of analysis on children’s weight showed that the amount of medicine used per unit body weight was negatively correlated with body weight.Results of drug utilization analysis showed that the dose of children drug utilization index(dCDUI)decreased with the increase of weight,and the d CDUI of children with low birth weight was>1,there was excessive application;the d CDUI of children with high body weight was<1,there was insufficient application.All the concentration of children drug utilization index(cCDUI)of children in different weight groups was>1,there was over-concentration application.CONCLUSIONS:The application of lienal polypeptide injection in children should be standardized to promote rational drug application.