2021年至2023年某院住院患者糖皮质激素类药物应用分析

Use of Glucocorticoids of Inpatients in a Hospital from 2021 to 2023

目的促进糖皮质激素(GC)类药物的临床合理使用。方法回顾性分析某院2021年至2023年1720例使用GC类药物住院患者的基本信息、疾病类型、所在科室、用药品种、用药频度(DDDs)、药物利用指数(DUI)、不合理用药情况及其类型。结果药物使用例数排名前5的分别为注射用氢化可的松琥珀酸钠(384例、22.33%),注射用甲泼尼龙琥珀酸钠(319例、18.55%),吸入用布地奈德混悬液(273例、15.87%),地塞米松磷酸钠注射液(255例、14.83%),甲泼尼龙片(170例、9.88%)。男性患者(51.05%)略多于女性患者(48.95%),年龄主要为50~79岁(53.78%),其次为<14岁(12.79%)。以呼吸内科使用例数最多(241例、14.01%),其次为感染科(235例、13.66%)和儿科(229例、13.31%)。不同科室使用量排名前5的全身性GC类药物均为注射用氢化可的松琥珀酸钠、注射用甲泼尼龙琥珀酸钠、地塞米松磷酸钠注射液、甲泼尼龙片、醋酸泼尼松片,其DDDs最大的科室分别为重症监护室(2556.34)、呼吸内科(1628.40)、重症监护室(604.32)、重症监护室(206.42)、肿瘤科(141.26),DUI均小于1。不合理用药类型主要有适应证不适宜(8例、0.47%),给药途径不适宜(5例、0.29%),遴选药品不适宜(7例、0.41%),用法用量不适宜(5例、0.29%)。结论该院GC类药物使用情况基本合理,但仍存在不合理用药问题。需进一步加强对该类药物的监管和医嘱专项点评,促进其临床应用的规范性、合理性及安全性。

Objective To promote the clinical rational use of glucocorticoids(GCs).Methods The basic information,disease type and department of 1720 inpatients using GCs in a hospital from 2021 to 2023 were retrospectively analyzed,as well as the drug variety,defined daily doses(DDDs),drug utilization index(DUI)and rationality of drug use.Results The top five GCs commonly used were Hydrocortisone Sodium Succinate For Injection(384 cases,22.33%),Methylprednisolone Sodium Succinate for Injection(319 cases,18.55%),Budesonide Suspension for Inhalation(273 cases,15.87%),Dexamethasone Sodium Phosphate Injection(255 cases,14.83%),Methylprednisolone Tablets(170 cases,9.88%)respectively.Among the inpatients using GCs,males(51.05%)were slightly more than females(48.95%),mainly aged in the range of 50 to 79 years(53.78%),followed by<14 years(12.79%).The inpatients using GCs were the most in the Department of Respiratory Medicine(241 cases,14.01%),followed by the Department of Infectious Disease(235 cases,13.66%)and Department of Pediatrics(229 cases,13.31%).The top five systemic GCs with high use amount in different departments were all Hydrocortisone Sodium Succinate For Injection,Methylprednisolone Sodium Succinate for Injection,Dexamethasone Sodium Phosphate Injection,Methylprednisolone Tablets and Prednisone Acetate Tablets;the corresponding DDDs was the highest in the Intensive Care Unit(ICU,2556.34),Department of Respiratory Medicine(1628.40),ICU(604.32),ICU(206.42),Department of Oncology(141.26)respectively,and the corresponding DUI was all lower than one.The main types of irrational drug use included inappropriate indications(eight cases,0.47%),inappropriate route of administration(five cases,0.29%),inappropriate drug selection(seven cases,0.41%),inappropriate usage and dosage(five cases,0.29%).Conclusion The use of GCs in this hospital is generally rational,but there are still problems of irrational drug use.We need to further strengthen the regulation and special comment of medical orders for GCs to promote the standardization,rationality and safety of its clinical application.