2015—2018年北京、上海和广州子宫内膜病变患者治疗药物使用情况分析  

Application of Therapeutic Drugs in Patients with Endometrial Disease in Beijing,Shanghai and Guangzhou from 2015 to 2018

作　　者：孙慧[1] 王萌萌[1] 庞艳玉[1] 黄燕萍[1] 王先利[1] 金经[1] 林诗舟 汤静 SUN Hui;WANG Mengmeng;PANG Yanyu;HUANG Yanping;WANG Xianli;JIN Jing;LIN Shizhou;TANG Jing(Dept.of Pharmacy,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院药学部,上海200011

出　　处：《中国医院用药评价与分析》2021年第12期1513-1519,共7页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：上海市优秀青年临床药师培养计划资助项目。

摘　　要：目的:了解北京、上海和广州3个城市子宫内膜病变治疗药物的使用情况及趋势,评价用药合理性。方法:自《医院处方分析合作项目》数据库中,提取2015—2018年北京、上海和广州子宫内膜病变患者药物治疗的处方数据,对治疗药物的用药频度(defined daily dose system,DDDs)和限定日费用(defined daily cost,DDC)等进行回顾性统计分析。结果:共纳入2015—2018年北京、上海和广州3个城市子宫内膜病变患者21 516张门诊处方和58 203条住院医嘱,其中子宫内膜增生患者予以药物保守治疗的处方(医嘱)共6 556张(份)。孕激素类及促性腺激素类药物使用最多,门诊患者孕激素类及促性腺激素类药物的处方数占比为30.06%(6 468/21 516)、销售金额占比为27.43%(1 158 434.00元/4 223 367.42元),住院患者孕激素类及促性腺激素类药物的医嘱数占比为0.35%(202份/58 203份)、销售金额占比为0.71%(37 206.70元/5 207 408.43元);其次为口服避孕药、左炔诺孕酮宫内节育系统和促性腺激素释放激素激动剂。口服孕激素中,甲羟孕酮、甲地孕酮、地屈孕酮和黄体酮的DDDs分别为735 600.40、28 090.88、24 127.00和12 857.00,DDC分别为0.70、40.35、24.08和37.42元,且DDDs均呈逐年升高趋势;口服避孕药中,炔雌醇环丙孕酮、屈螺酮炔雌醇和去氧孕烯炔雌醇的使用例次数分别为260、139和61例次,炔雌醇环丙孕酮的使用多于屈螺酮炔雌醇、去氧孕烯炔雌醇;6 556张(份)子宫内膜增生患者予以药物保守治疗的处方(医嘱)中,单独使用孕激素类及促性腺激素类药物处方(医嘱)共4 909张(份),占74.88%。结论:门诊是医师为子宫内膜病变患者开具孕激素类及促性腺激素类药物的主要场所,子宫内膜病变处方以孕激素类及促性腺激素类药物单药治疗为主,主要为口服孕激素,其中甲羟孕酮、甲地孕酮、地屈孕酮和黄体酮的使用居多,且具有良好的药物经济性,甲羟孕�OBJECTIVE: To investigate the application and trend of therapeutic drugs in patients with endometrial disease in Beijing,Shanghai and Guangzhou,and to evaluate the application rationality of drugs. METHODS:Prescription data of patients with endometrial disease in Beijing,Shanghai and Guangzhou from 2015 to 2018 were extracted from the hospital prescription analysis cooperation project database,the defined daily dose system( DDDs)and defined daily cost( DDC) were analyzed retrospectively. RESULTS: A total of 21 516 outpatient prescriptions and 58 203 inpatient medical orders were collected form patients with endometrial disease in Beijing,Shanghai and Guangzhou from 2015 to 2018,among which 6 556 prescriptions and medical orders were for conservative treatment of patients with endometrial hyperplasia. Progesterone and gonadotropin drugs were the most used,and the proportion of prescriptions and consumption sum of progesterone and gonadotropin drugs in outpatients were respectively 30. 06%( 6 468/21 516) and 27. 43%( 1 158 434. 00 yuan/4 223 367. 42 yuan),the proportion of medical orders and consumption sum of progesterone and gonadotropin drugs in inpatients were respectively 0. 35%( 202/58 203) and0. 71%( 37 206. 70 yuan/5 207 408. 43 yuan),followed by oral contraceptives,levonorgestrel intrauterine birth control system and gonadotropin-releasing hormone agonist. In oral progesterone,DDDs of medroxyprogesterone,medroxyprogesterone,dydrogesterone and progesterone were respectively 735 600. 40,28 090. 88,24 127. 00 and 12 857. 00,and DDC were respectively 0. 70,40. 35,24. 08 and 37. 42 yuan,and the DDDs were in an increasing trend year by year. In oral contraceptives,the number of case-times with ethinylestradiol cyproterone,drospirenone ethinylestradiol and deoxyprogesterone ethinylestradiol were respectively 260,139 and 61,and the application of ethinylestradiol cyproterone was more than that of drospirenone ethinylestradiol and deoxyprogesterone ethinylestradiol.Among 6 556 prescriptions and medical orders for c

关 键 词：子宫内膜增生 孕激素 口服避孕药 促性腺激素释放激素激动剂 

分 类 号：R984[医药卫生—药品]