云南某院丙型病毒性肝炎合并疾病用药横断面分析及DDI研究

Cross-Sectional Analysis and DDI Study of Drugs Used for Hepatitis C Combined with Disease in a Hospital in Yunnan Province

目的:通过对昆明市第三人民医院的丙型病毒型肝炎患者合并疾病、合并疾病用药情况以及DDI研究,规范临床合理用药。方法:统计我院2021年1月~2022年12月期间诊断为“丙型肝炎病毒感染”或“丙型病毒性肝炎”的患者,同时合并其他疾病,按基线情况、抗病毒治疗方案、合并疾病用药、布及比例,了解我院丙型病毒性肝炎患者合并疾病及合并用药情况。结果:研究对象中,男性占比70%,女性占比30%;年龄在45岁以上的患者占总数的85%。最常见的合并疾病是艾滋病(41%)和高血压(34%),合并疾病最少的是慢性乙型肝炎,占6%。合并艾滋病的患者中,91.5%通过静脉吸毒感染丙肝和艾滋病,最常用的抗HIV药物是拉米夫定(65.9%)。在合并高血压的丙肝患者中使用最多的降压药物是氨氯地平,共238人使用。112位血脂异常的患者使用了降脂药物,使用阿托伐他汀的人数最多。70位合并慢性乙型病毒性肝炎的患者使用了抗病毒药物,替诺福韦最多。合并糖尿病患者中使用门冬胰岛素的患者最多(168人)。所选取的研究对象使用的DAAs有3种,分别是索磷布韦维帕他韦、艾尔巴韦格拉瑞韦和来迪派韦索磷布韦。在纳入研究的2800例患者中,共计336例存在禁止使用DDI风险,616例存在潜在DDI风险。结论:丙肝患者合并疾病排名前5位为:艾滋病、高血压、高尿酸血症、糖尿病、血脂异常。合并疾病用药与DAAs存在DDI风险。

Object: Through the study of hepatitis C patients with combined diseases, drug use with combined diseases and DDI in Kunming Third People’s Hospital, the clinical rational drug use was standardized. Methods: The patients diagnosed with “hepatitis C virus infection” or “hepatitis C virus” in our hospital during January 2021 to December 2022 were analyzed and combined with other diseases. Based on the baseline situation, antiviral treatment plan, combined drug use, drug use and proportion, the situation of patients with hepatitis C virus infection and combined drug use in our hospital was investigated. Results: The study subjects were 70% male and 30% female;Patients over the age of 45 account for 85% of the total. The most common co-morbidity was HIV/AIDS (41%) and hypertension (34%), while the least common co-morbidity was chronic hepatitis B (6%). Among patients with HIV, 91.5% contracted hepatitis C and AIDS through intravenous drug use, and the most commonly used anti-HIV drug was lamivudine (65.9%). Amlodipine was the most commonly used antihypertensive drug in patients with hepatitis C and hypertension, used by 238 patients. 112 patients with dyslipidemia were treated with lipid-lowering drugs, with atorvastatin being the largest group. Seventy patients with chronic viral hepatitis B were treated with antivirals, tenofovir being the most common. The largest number of patients with combined diabetes (168) used insulin aspartate. Three types of DAAs were used by the selected subjects, namely Sofosbuvir, Vipataivir, Elbavirgrevir, and Ledipavir. Of the 2,800 patients included in the study, a total of 336 were at risk of prohibited DDI use and 616 were at potential DDI risk. Conclusion: The top 5 diseases associated with hepatitis C patients were: AIDS, hypertension, hyperuricemia, diabetes, dyslipidemia. There is a risk of DDI with disease drugs combined with DAAs.