目的:探究安徽省、四川省重点监控药品政策对样本医院质子泵抑制剂(PPI)使用的影响,为减少质子泵抑制剂滥用现象、促进质子泵抑制剂合理使用、完善与推进重点监控药品管理政策提供依据。方法:以全国各省份监控目录形成的重点监控药品库...目的:探究安徽省、四川省重点监控药品政策对样本医院质子泵抑制剂(PPI)使用的影响,为减少质子泵抑制剂滥用现象、促进质子泵抑制剂合理使用、完善与推进重点监控药品管理政策提供依据。方法:以全国各省份监控目录形成的重点监控药品库为基础,结合安徽省、四川省的重点监控药品目录,综合考虑药品典型性及临床替代品等因素,遴选出安徽省奥美拉唑被监控品种(商品名)作为样本药品,奥美拉唑未被监控品种及4种PPI(通用名)作为对照药品,另外四川省纳入5种PPI(通用名)作为研究对象,进一步提取安徽省3家三级医院2014年11月至2017年9月的月度数据、四川省成都市9家三级医院2014年一季度至2017年一季度的季度数据。研究通过有对照的间断时间序列(interrupted time series,ITS)模型,分析样本药品及对照药品用量与金额的变化。结果:(1)安徽省、四川省实施重点监控政策后,除四川省埃索美拉唑使用下降趋势不显著外,被纳入监控目录的PPI品种的用量、金额均出现显著下降(P值均小于0.05);(2)安徽实施重点监控政策后,奥美拉唑未被监控品种(商品名)使用显著上升,所有奥美拉唑(通用名)使用显著下降(P值均小于0.05)。(3)安徽省将奥美拉唑纳入监控目录后,其他PPI品种(通用名)的使用显著下降,PPI类药品的整体使用受到有效限制(P值均小于0.05)。结论:安徽省重点监控药品政策有效限制了奥美拉唑的使用,同时使PPI类药品的整体使用显著下降。四川省重点监控药品政策使纳入监控目录的5种PPI整体的使用受到有效限制,政策效果显著。展开更多
CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a syste...CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a systematic review and meta-analysis to evaluate the impact of CYP3A4 polymorphism on platelet reactivity after clopidogrel treatment and the outcomes of patients.A systematic literature search(up to 7th October,2019)was performed on the PubMed,EMBASE,Cochrane Library,clinicaltrials.gov,and Chinese databases,including China National Knowledge Infrastructure(CNKI)and Wan Fang Data.Cohort studies or case-control studies evaluated platelet reactivity and patients‟outcomes in different genotype patients.The Review Manager software was used for data analysis,and the NOS scale was used to assess the quality of included studies.A total of 18 articles were included in the Meta-analysis.The results showed the platelet reactivity after clopidogrel administration had no significant difference between CYP3A4 variant carriers and non-carriers.The occurrence of composite ischemic events or stent thrombosis had no significant difference between CYP3A4 variant carriers and non-carriers,either.In conclusion,there was no significant association between CYP3A4 polymorphism and clopidogrel response in patients with cardio-cerebrovascular diseases.展开更多
文摘目的:探究安徽省、四川省重点监控药品政策对样本医院质子泵抑制剂(PPI)使用的影响,为减少质子泵抑制剂滥用现象、促进质子泵抑制剂合理使用、完善与推进重点监控药品管理政策提供依据。方法:以全国各省份监控目录形成的重点监控药品库为基础,结合安徽省、四川省的重点监控药品目录,综合考虑药品典型性及临床替代品等因素,遴选出安徽省奥美拉唑被监控品种(商品名)作为样本药品,奥美拉唑未被监控品种及4种PPI(通用名)作为对照药品,另外四川省纳入5种PPI(通用名)作为研究对象,进一步提取安徽省3家三级医院2014年11月至2017年9月的月度数据、四川省成都市9家三级医院2014年一季度至2017年一季度的季度数据。研究通过有对照的间断时间序列(interrupted time series,ITS)模型,分析样本药品及对照药品用量与金额的变化。结果:(1)安徽省、四川省实施重点监控政策后,除四川省埃索美拉唑使用下降趋势不显著外,被纳入监控目录的PPI品种的用量、金额均出现显著下降(P值均小于0.05);(2)安徽实施重点监控政策后,奥美拉唑未被监控品种(商品名)使用显著上升,所有奥美拉唑(通用名)使用显著下降(P值均小于0.05)。(3)安徽省将奥美拉唑纳入监控目录后,其他PPI品种(通用名)的使用显著下降,PPI类药品的整体使用受到有效限制(P值均小于0.05)。结论:安徽省重点监控药品政策有效限制了奥美拉唑的使用,同时使PPI类药品的整体使用显著下降。四川省重点监控药品政策使纳入监控目录的5种PPI整体的使用受到有效限制,政策效果显著。
基金National Natural Science Foundation of China(Grant No.81803497)。
文摘CYP3A4 plays a critical role in clopidogrel activation in the liver.The polymorphism of CYP3A4 may have an important effect on clopidogrel response in patients with cardio-cerebrovascular diseases.We conducted a systematic review and meta-analysis to evaluate the impact of CYP3A4 polymorphism on platelet reactivity after clopidogrel treatment and the outcomes of patients.A systematic literature search(up to 7th October,2019)was performed on the PubMed,EMBASE,Cochrane Library,clinicaltrials.gov,and Chinese databases,including China National Knowledge Infrastructure(CNKI)and Wan Fang Data.Cohort studies or case-control studies evaluated platelet reactivity and patients‟outcomes in different genotype patients.The Review Manager software was used for data analysis,and the NOS scale was used to assess the quality of included studies.A total of 18 articles were included in the Meta-analysis.The results showed the platelet reactivity after clopidogrel administration had no significant difference between CYP3A4 variant carriers and non-carriers.The occurrence of composite ischemic events or stent thrombosis had no significant difference between CYP3A4 variant carriers and non-carriers,either.In conclusion,there was no significant association between CYP3A4 polymorphism and clopidogrel response in patients with cardio-cerebrovascular diseases.
