590例使用静注人免疫球蛋白适应症合理性分析

Analysis of the Rationality of Indications for 590 Cases of Intravenous Injection of Human Immunoglobulin

目的通过对我院静注人免疫球蛋白(PH4)临床使用适应症的合理性分析,促进其临床应用的规范性和合理性。方法回顾性地分析我院2022年1月1日至2022年12月31日使用静注人免疫球蛋白的590例急诊患者,运用Excel软件对患者的基本信息包括患者年龄、临床诊断、临床用药科室等进行统计分析。以药品说明书、美国食品药品监督管理局(FDA)批准的7种适应症和相关疾病诊疗指南为依据,来评价我院IVIG用药适应症的合理性。结果590例使用IVIG的患者中,年龄为0~100岁,其中16~60岁的患者187例(比31.69%)最多;其次为4~7岁患者164例(占比27.80%)。使用IVIG的患者分布于8个科室,主要集中于小儿血液、血液科、小儿内科,上述3个科室的病例数所占比例高达76.95%;符合说明书用药319例,超说明书用药271例,临床指南不推荐的使用2例,临床指南中未提及用药16例,其余均为临床指南推荐使用。结论我院静注人免疫球蛋白(PH4)使用存在超说明书现象,应加强监管并制订相关临床使用规范,促进合理用药。

OBJECTIVE By analyzing the rationality of the clinical indications for intravenous injection of human immunoglobulin(PH4)in our hospital,we aimed to promote the standardization and rationality of its clinical application.METHODS Retrospective analysis of 590 patients using IVIG in our hospital in 2022,use Excel software to statistically analyze the basic information of patients,including patient age,clinical diagnosis,clinical medication department,etc.Based on the drug instructions,7 indications approved by the US Food and Drug Administration(FDA),and related disease diagnosis and treatment guidelines,evaluate the rationality of the indications for IVIG medication in our hospital.RESULTS Among the 590 patients who used IVIG,the age range was 0-100 years old,with 187 patients aged 16-60(31.69%)having the highest incidence;Next were 164 patients aged 4-7(accounting for 27.80%).The patients using IVIG were distributed in 8 departments,mainly concentrated in pediatric hematology,hematology,and pediatric internal medicine.The proportion of cases in these three departments was as high as 76.95%;319 cases were treated according to the instructions,271 cases were treated beyond the instructions,2 cases were not recommended by clinical guidelines,and 16 cases were not mentioned in clinical guidelines.The rest were recommended by clinical guidelines.CONCLUSION The use of intravenous human immunoglobulin(PH4)in our hospital exceeds the instructions,and we should strengthen supervision and develop relevant clinical usage standards to promote rational drug use.