抗病毒治疗的慢性乙型肝炎患者合并用药调查分析  

A survey and analysis of combined medication in chronic hepatitis B patients undergoing anti-viral therapy

作　　者：张月宁[1] 张世斌[1] 丁惠国[1] 金瑞[1] 邱新野[2] 

机构地区：[1]首都医科大学附属北京佑安医院肝病消化中心,100069 [2]首都医科大学附属北京佑安医院药学中心,100069

出　　处：《北京医学》2015年第12期1158-1160,共3页Beijing Medical Journal

摘　　要：目的了解核苷（酸）类似物抗病毒治疗的慢性乙型肝炎患者合并用药情况现状。方法对2015年5~8月北京佑安医院门诊接诊的应用核苷（酸）类药物抗病毒治疗的部分慢性乙型肝炎患者进行问卷调查,调查内容包括抗病毒药物、伴随疾病、目前合并用药等。查阅检索药物适应证、禁忌证、用法用量、不良反应及药物-药物间相互作用等。结果对1 782例患者进行问卷调查,抗病毒单一药物治疗1 338例。合并服用其他药物1 052例（59.0%）,其中1种药物562例（53.4%）,2种290例（27.6%）,3种117例（11.1%）,4种53例（5.0%）,5种17例（1.6%）,6种及以上13例（1.2%）。有1种伴随疾病需合并用药者212例,2种149例,3种以上24例。合并用药种类达91种（肝病辅助用药27种,29.7%）,其中39种（42.9%）不在相关疾病指南或专家共识所推荐的治疗药物中。合并使用的药物中有潜在肝脏不良反应的34种（37.4%）,存在药物相互反应的亦有34种（37.4%）。结论抗病毒治疗的慢性乙型肝炎患者合并用药十分普遍,对肝脏的潜在毒性反应及药物-药物相互作用未能得到充分重视。Objective To investigate the concurrent combined medication in chronic hepatitis B patients undergoing anti-viral therapy with nucleotide analogues.Methods A survey was carried out in chronic hepatitis B outpatients at Center of Hepatology and Gastroenterology, Beijing You＇an Hospital, during May to August 2015. The questionnaire included the kinds of nucleotide analogues that patients were taking, the concomitant diseases and concurrent combined drugs. A systemic review of the indications, contraindications, adverse reactions and drug-drug interactions was evaluated.Results There were 1 782 cases studied, mono-therapy with any of the five nucleotide analogues accounted for 1 338 patients. Combined medication accounted for 1 052（59.0%） patients, with one medication in 562（53.4%）, two medications in290（27.6%）, three medications in 117（11.1%）, four medications in 53（5.0%）, five medications in 17（1.6%） and six medications in and above in 13（1.2%）. The categories of concurrent combined drugs were up to 91,among which 39（42.9%） categories were not recommended by the related guidelines. Thirty-four（37.4%） categories of drugs had potential adverse reactions against the liver and drug- drug interactions were existed among 34（37.4%） categories of drugs taken by the patients simultaneously. Conclusions The prevalence of combined medication in chronic hepatitis B patients is high and the potential adverse reactions against the liver and drug-drug interactions are generally neglected.

关 键 词：慢性乙型肝炎 抗病毒 合并用药 药物-药物相互作用 

分 类 号：R512.62[医药卫生—内科学]