摘要
目的:了解冠心病住院患者用药现状,为相关决策提供参考。方法:通过医保系统提取绵阳地区8家医疗机构2014年1月-2016年12月冠心病患者病历资料,每家医疗机构抽取200份,采用Excel 2007、Access 2007、SPSS 19.0软件对患者性别、年龄、用药金额、药品品种、药品联用情况等进行统计分析。结果:共纳入1 600例患者,其中男性893例,女性707例,平均年龄(73.9±10.2)岁。药品费用占住院总费用的35.2%,冠心病治疗药物费用占药品费用的72.4%,辅助治疗用药中的中成药及4种改善循环的中药提取成分的化学药物费用占冠心病治疗药物费用的37.8%。主要治疗用药中,调脂药物使用率为80.8%,血管紧张素转化酶抑制剂(ACEI)和血管紧张素受体拮抗药(ARB)的使用率为46.9%。抗血小板药物联用质子泵抑制剂(PPIs)者占抗血小板药物使用者的54.9%;14例患者使用了短效的硝苯地平片;42例患者联用了氯吡格雷和奥美拉唑。结论:左卡尼汀等辅助用药费用占比较高;ACEI或ARB、调脂药物在冠心病患者中使用比例较低,选用短效钙通道阻滞药、双嘧达莫欠合理;PPIs使用指征控制不严;中成药滥用较为明显。
OBJECTIVE:To investigate the situation of drug use in CHD inpatients,and to provide reference for relevant decision-making. METHODS:Medical records of CHD patients were collected by medical insurance system from 8 medical institutions of Mianyang area during Jan. 2014-Dec. 2016. Each 200 medical records were collected from each medical institution and then analyzed statistically by EXCEL 2007,ACCESS 2007,SPSS 19.0 software in respects of patient's gender and age,drug amount,drug type,drug combination. RESULTS:A total of 1 600 patients were included,involving 983 male and 707 female with average age of(73.9±10.2)years old. Drug cost ratio was 35.2% of total hospitalization cost;CHD treatment drugs accounted for 72.4%of the total drug cost. Among adjuvant therapy drugs,the cost of Chinese patent medicines and 4 chemical medicines containing TCM extracted component which could improve circulation accounted for 37.8% of cardiovascular drug cost. Among main therapy drugs,the utilization rate of lipid-modulating drugs was 80.8%,and that of ACEI and ARB was 46.9%. The patients receiving antiplatelet drug combined with PPI accounted for 54.9% of the patients receiving antiplatelet drug. Fourteen patients were treated with short-acting Nifedipine tablets. Forty-two patients were treated with clopidogrel and omeprazole. CONCLUSIONS:The utilization of adjuvant therapy drugs such as L-carnitine show high cost ratio. ACEI or ARB,lipid-lowering drugs take up low proportion in CHD patients. The use of short-acting Calcium channel blocker(CCB)and dipyridamole are unreasonable. The indication control of PPIs is lax and the abuse of Chinese patent medicine is obvious.
出处
《中国药房》
CAS
北大核心
2017年第32期4487-4492,共6页
China Pharmacy
基金
四川省基层卫生事业发展研究中心重点项目(No.SWFZ16-Z-07)
关键词
冠心病
用药分析
现状调查
合理用药
Coronary heart disease
Analysis of drug use
Status investigation
Rational drug use
