2011~2018年我国六城市肾移植术后门诊患者的免疫抑制剂应用分析  

Analysis of the Application of Immunosuppressants for Outpatient Kidney Transplant Recipients Among Six Cities in China from 2011 to 2018

作　　者：侯文婧 林俊[2] 李丹丹[1] 沈素[1] 温爱萍[1] HOU Wenjing;LIN Jun;LI Dandan(Department of Pharmacy,Department of Urology,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing,100050)

机构地区：[1]首都医科大学附属北京友谊医院药剂科,北京100050 [2]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《中国中西医结合肾病杂志》2021年第4期318-320,共3页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的:了解与分析肾移植术后患者在医院门诊开具免疫抑制剂的情况。方法:选取2011年—2018年我国六城市肾移植患者的门诊处方,对免疫抑制剂选择及联用情况等进行统计分析。结果:共纳入174749例次肾移植患者,男女比例约为2∶1,平均年龄(42.5±9.4)岁,一次门诊就诊平均开具(4.7±1.7)种药品。在免疫抑制剂的使用方面,排在前3位的是吗替麦考酚酯、他克莫司和环孢素,分别占全部患者例次的28.8%、28.2%和15.7%。六城市中开具吗替麦考酚酯的患者均明显多于麦考酚酸,但对于他克莫司与环孢素、泼尼松与甲泼尼龙的选择,存在地区差异。免疫抑制剂的常见联用模式为“他克莫司+吗替麦考酚酯”、“环孢素+吗替麦考酚酯”的两药联用,以及“他克莫司+吗替麦考酚酯+泼尼松”、“他克莫司+吗替麦考酚酯+甲泼尼龙”、“环孢素+吗替麦考酚酯+泼尼松”的三药联用。具体品种的选择在八年研究期间以及各城市间存在差异。结论:我国肾移植术后患者用药符合指南推荐,但具体品种选择存在地区差异。Objective:To investigate and analyze the application of immunosuppressants for outpatient kidney transplant recipients(KTRs).Methods:Outpatient prescriptions for KTRs were selected among six cities in China from 2011 to 2018,and the selection and co-therapy patterns for immunosuppressants were analyzed.Results:A total of 174,749 KTRs were included,with a male to female ratio of about 2∶1 and a mean age of(42.5±9.4)years.They were prescribed(4.7±1.7)drugs in one visit.In terms of the selection of immunosuppressants,the top 3 were mycophenol mofetil(MMF),tacrolimus and cyclosporine,which accounted for 28.8%,28.2%and 15.7%of the total patients,respectively.The number of patients prescribed MMF was significantly higher than that prescribed enteric-coated mycophenolate sodium(EC-MPS)in the six cities,but there were regional differences in the choice for tacrolimus/cyclosporin,and prednisone/methylprednisolone.The five most common patterns were two-drug combination(“tacrolimus+MMF”and“cyclosporin+MMF”)and triple combination(“tacrolimus+MMF+prednisone”,“tacrolimus+MMF+methylprednisolone”and“cyclosporin+MMF+prednisone”).The selection of different patterns varied over the eight-year study period and between cities.Conclusion:The use of immunosuppressive agents was in line with the guidelines,but the selection and combination patterns were different among different regions.

关 键 词：肾移植 门诊处方 用药品种 免疫抑制剂 

分 类 号：R699.2[医药卫生—泌尿科学]