某院住院患者他汀类药物使用情况调查与分析  

Investigation and analyses of clinical application of statin drugs among inpatients in a certain hospital

作　　者：曹尉尉[1] 吴杲[1] 蒋红[1] 吴汉斌[2] 胡云英[3] 

机构地区：[1]解放军第四一一医院药械科,上海200081 [2]上海市东方医院 [3]蚌埠医学院

出　　处：《海军医学杂志》2014年第4期256-259,共4页Journal of Navy Medicine

摘　　要：目的分析某三甲医院住院患者他汀类药物临床应用状况,为临床合理用药提供参考。方法 2013年某三甲医院应用他汀类药物的住院患者共2 561例,收集其疾病诊断、检验结果和住院期间所有用药信息,按《中国成人血脂异常预防指南》("指南")将研究对象进行危险分层,了解研究临床他汀类药物应用与"指南"的差距并分析可能的原因。结果以心脑血管疾病(以心内科、神经内科计)住院的患者共1 480例(57.79%);具有完整危险分层和血脂指标资料者1 487例(58.06%),其中极高危162例(10.89%),高危852例(57.30%),中危117例(7.89%),低危356例(23.94%);血脂指标符合"指南"药物治疗标准的1 265例(49.39%);低密度脂蛋白胆固醇(LDL-C)≥4.92 mmol/L的136例(10.75%),≥4.14 mmol/L的271例(21.42%),≥2.60 mmol/L的368例(29.09%),≥2.07 mmol/L的490例(38.74%)。他汀类药物治疗后LDL-C达到目标值的34例(2.69%),有疑似他汀类药物不良反应的458例(17.88%),出现可能为他汀类药物相互作用的2 119例次。结论该医院住院患者他汀类药物临床应用与"指南"存在着较大差距,临床医生应加强调脂知识学习,进一步规范他汀类药物的临床应用,避免过度用药。Objective To analyze clinical application of statin drugs among inpatients in a certain 3-A-grade tertiary hospital, and to provide evidence for rational application of antimicrobials clinically. Methods There were altogether 2561 hospitalized patients that used statins in a 3-A-grade tertiary hospital in 2013. Clinical data including diagnoses of diseases, laboratory test results and drug applications were collected and risk stratification was performed in accordance with ＂the 2007 Guidelines to China Lipid Control＂ , so as to know the difference or the gap between actual clinical application of statins and the directions as specified in the Guidelines and to analyze possible reasons as well. Results There were 1480 cases admitted into the hospital due to cardiovascular and cerebrovascular disorders, accounting for 57.79% of the study subjects. There were 1487 cases with complete information of risk stratification and lipid indexes, which accounted for 58.06% of the subjects. Of all the cases, 162 were very high risk cardiovascular cases （ 10.89% ） , 852 were high risk cardiovascular cases （57.30%） , 117 were medium risk cardiovascular cases （7.89%） and 356 were low risk cardiovascular eases （23.94%）. There were only 1265 cases, whose lipid indexes were complied with the Guidelines, accounting for 49.39% of the subjects ; there were 136 cases with low-density lipoprotein-cholesterol （LDL-C） ≥4.92mmol/L, which accounted for 10.75% ; there were 271 cases with LDL-C ≥14.14mmol/L, which accounted for 21.42% ; there were 368 cases with LDL-C ≥2.6 mmol/L, which accounted for 29.09% ; and there were 490 cases with LDL-C ≥2.07mmol/L, which accounted for 38.74%. After treatment with statins, 34 cases achieved therapeutic target lipid values in LDL-C, which accounted for 2.69%. There were 458 cases that had suspicious statin adverse drug reactions, accounting for 17.88% of the studied subjects, and there were 2119 cases that had possible statin-drug interactions. Conclusion There existed a

关 键 词：他汀类药物 合理用药 调脂药 血脂 危险分层 

分 类 号：R969.3[医药卫生—药理学]