33398例次肾移植术后高血压患者降血压药物利用分析  

Analysis of Antihypertensive Drug Utilization in 33398 Patients with Hypertension After Renal Transplantation

作　　者：李丹[1,2] 秦舟[1] 吴斌[1] 徐珽[1] LI Dan;QIN Zhou;WU Bin;XU Ting(Department of Pharmacy,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Medicine,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院临床药学部(药剂科),成都610041 [2]四川大学华西临床医学院,成都610041

出　　处：《医药导报》2021年第3期389-394,共6页Herald of Medicine

基　　金：2017年《医院处方分析》课题成都地区项目(312120242);2017年四川省医学会高血压疾病(施慧达)专项科研基金(2017SHD005)。

摘　　要：目的分析2015—2018年全国5个城市肾移植术后高血压患者特征及降血压药物使用情况,为临床合理用药提供参考。方法基于《医院处方分析合作项目》随机抽取的多中心处方大数据,采用世界卫生组织(WHO)推荐的药物利用分析方法,对降血压药物的使用情况进行分析。结果抽取5个城市共40家三级医院(不含军队医院)共计33398例肾移植术后高血压患者。男女比例为2.56:1。中位年龄43岁,41~64岁年龄段患者占比最高(50.93%)。患者主要来源于门诊(81.94%)。75.71%肾移植患者使用降血压药物时没有高血压诊断记录。各类降血压药物中,钙通道阻断药(CCB)[(二氢吡啶类CCB,dCCB)31.15%,非二氢吡啶类CCB(ndCCB)10.54%]、血管紧张肽Ⅱ受体拮抗剂(ARB,24.86%)、β受体阻断药(βBs,21.16%)类药物处方量位列前三。CCB与ARB类中处方量前三的药物处方日剂量(PDD)/确定限定日剂量(DDD)值均大于1。最常用的单药降血压方案为dCCB,最常用的联合用药方案是dCCB+ARB及dCCB+βB。结论各地区降血压药物使用基本合理,但在疾病诊断记录及药物剂量方面尚需进一步加强管理,在治疗时应综合考虑患者年龄、并发症、用药依从性和经济状况,遵循个体化治疗原则。Objective To analyze the characteristics of patients with hypertension after renal transplantation and the utilization of antihypertensive drugs in 5 cities in China from 2015 to 2018,so as to provide reference for clinical rational use of drugs.Methods Based on the multi-center prescription data which were randomly selected from the Hospital Prescription Analysis Cooperation Project,the utilization of antihypertensive drugs was analyzed by the drug utilization analysis method recommended by WHO.Results The data of 33398 patients with hypertension after renal transplantation were extracted from 40 grade III hospitals(excluding military hospitals)in 5 cities.The ratio of male to female was 2.56.The median age was 43 years old.Patients in the middle age(from 41 to 64 year old)group accounted for the highest proportion(50.93%).The patients mainly purchased drugs in the outpatient pharmacy(81.94%).There was no diagnostic record of hypertension in 75.71%of the patients after renal transplant when using antihypertensive drugs.Among all classes of antihypertensive drugs,the number of calcium channel blockers(CCB)[dihydropyridine CCB(dCCB)31.15%,non-dihydropyridine CCB(ndCCB)10.54%],angiotensin II receptor blockers(ARB,24.86%)andβreceptor blockers(βBs,21.16%)prescription were the top three.The PDD/DDD values of these three kinds of drugs were more than 1.The most commonly used single-drug antihypertensive regimen was dCCB,and the most commonly used combination regimen is dCCB+ARB and dCCB+βB.Conclusion The utilization of antihypertensive drugs in these 5 cities is basically reasonable.But it is still necessary to standardize the diagnostic records and adjustment of drug dosage.During the treatment,the patients'ages,complications,medication compliance and economic status should be considered comprehensively,and the individualized treatment principles should be followed.

关 键 词：药物利用分析 肾移植 高血压 

分 类 号：R972.4[医药卫生—药品] R544.1[医药卫生—药学]