慢性乙型病毒性肝炎患者肝胆疾病辅助用药应用分析

Application of Hepatoprotective Drugs for Patients with Chronic Hepatitis B

目的为临床合理应用肝胆疾病辅助用药提供参考。方法统计医院2021年肝胆疾病辅助用药总销售金额、用药频度(DDDs)、限定日费用(DDC)、药物利用指数(DUI)等,回顾性分析有至少2次肝功能血清学指标监测记录且监测期间固定使用肝胆疾病辅助用药方案和规律配药的慢性乙型病毒性肝炎(CHB)患者的肝功能水平。对影响CHB患者肝功能指标的因素进行单因素分析,对有统计学意义的单因素分析结果进行Logistic多因素回归分析。结果销售金额和DDDs排前3位的肝胆疾病辅助用药均为甘草酸二铵肠溶胶囊、熊去氧胆酸胶囊、双环醇片(25 mg);DDC排前3位的分别为熊去氧胆酸胶囊、双环醇片(25 mg)、双环醇片(50 mg)。所有肝胆疾病辅助用药的DUI均未超过1。有至少2次肝功能血清学指标监测记录且监测期间固定使用肝胆疾病辅助用药方案和规律配药的CHB患者占37.31%(288/772)。单因素分析结果显示,年龄低于40岁,丙氨酸氨基转移酶(ALT)或天门冬氨酸氨基转移酶(AST)水平异常,使用含双环醇片方案对CHB患者肝功能指标有显著影响(P<0.05)。Logistic多因素回归分析结果显示,ALT水平异常的CHB患者肝功能指标改善更显著(P<0.05)。结论该院感染门诊CHB患者应用肝胆疾病辅助用药相对合理,临床应更多关注ALT水平正常CHB患者的肝胆疾病辅助用药治疗,加强用药监督,确保临床疗效。

Objective To provide a reference for the rational use of hepatoprotective drugs in the clinic.Methods The consumption sum,defined daily dose system(DDDs),defined daily cost(DDC)and drug utilization index(DUI)of hepatoprotective drugs were analyzed,and the liver function of CHB patients who had at least two monitoring records of liver function serological indicators using a fixed hepatoprotective drugs regimen during the monitoring period with regular dosing were analyzed retrospectively.The univariate analysis was conducted on the factors affecting liver function indicators in CHB patients,and the Logistic regressions analysis was conducted on univariate analysis results with statistical significance.Results The top three hepatoprotective drugs in terms of the consumption sum and DDDs were Diammonium Glycyrrhizinate Enteric-Coated Capsules,Ursodeoxycholic Acid Capsules,and Bicyclol Tablets(25 mg).The top three drugs in terms of DDC were Ursodeoxycholic Acid Capsules,Bicyclol Tablets(25 mg),Bicyclol Tablets(50 mg).The DUI of all the hepatoprotective drugs did not exceed 1,and 37.31%(288/772)of CHB patients had at least two monitoring records of liver function serological indicators who used a fixed hepatoprotective drugs regimen during the monitoring period with regular dosing.The results of the univariate analysis showed that age<40 years old,abnormal levels of alanine aminotransferase(ALT)or aspartate aminotransferase(AST),taking medication regimens containing Bicyclol Alcohol Tablets had a significant impact on liver function indicators in CHB patients(P<0.05).The results of the Logistic regressions analysis showed that patients with abnormal ALT levels had better improvement in liver function(P<0.05).Conclusion The application of hepatoprotective drugs in the infection department of the hospital was relatively reasonable.More attention should be paid clinically to the medication regimens of hepatoprotective drugs for CHB patients with normal ALT,and drug supervision should be strengthened to ensure clinical efficacy.