DUR联合DUE模式对恶性肿瘤化疗患者保肝药物应用效果的影响  

Effect of DUR combined with DUE on the application of hepatoprotective drugs in patients with malignant tumors undergoing chemotherapy

作　　者：王金利 石慧 WANG Jinli;SHI Hui(Department of Pharmacy,Huishan District People's Hospital,Wuxi 214187,Jiangsu,China)

机构地区：[1]惠山区人民医院药剂科,江苏无锡214187

出　　处：《贵州医科大学学报》2022年第11期1349-1353,共5页Journal of Guizhou Medical University

基　　金：江苏省药学会-奥赛康临床药学基金科研项目(A201948)。

摘　　要：目的探讨临床药师采用药物利用评价(DUR)联合药物利用评估(DUE)模式对恶性肿瘤化疗患者保肝药物应用的影响。方法随机选取220例化疗后使用保肝药物的恶性肿瘤患者作为对照组和干预组,每组110例;对照组为回顾性分析,干预组根据DUE标准由临床药师指导保肝药物使用;依据DUE标准选择13种保肝药物,以药物利用指数(DUI)<1(日处方剂量较常规用药剂量偏低)及DUI>1(日处方剂量超出常规用药剂量)评价保肝药物使用的合理性,以血清丙氨酸氨基转移酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)三项指标评价保肝药物使用前后的肝功能。结果在选择的13种保肝药物中,对照组有3种药物DUI>1、8种药物DUI<1、2种药物DUI=1,而干预组有10种药物DUI=1、仅3种药物DUI<1,干预组DUR优于对照组(P<0.05);与对照组比较,干预组患者血清ALT、AST及TBIL水平均较用药前明显改善,差异有统计学意义(P<0.05)。结论临床药师利用DUR联合DUE模式干预恶性肿瘤化疗患者保肝药物应用,可起到较好保护肝功能的作用。Objective To explore the effect of drug utilization review(DUR)combined with drug utilization evaluation(DUE)adopted by clinical pharmacists on the application of hepatoprotective drugs in patients with malignant tumors undergoing chemotherapy.Methods A total of 220 patients with malignant tumor who received hepatoprotective drugs after chemotherapy were randomly divided into control(n=110)and intervention groups(n=110).Control group was retrospectively analyzed,while intervention group was given with hepatoprotective drugs guided by clinical pharmacists according to DUE standards.Thirteen hepatoprotective drugs were selected according to DUE standard.The rationality of the use of hepatoprotective drugs was evaluated by drug utilization index(DUI)<1(the daily prescribed dose was lower than that of conventional drugs)and DUI>1(the daily prescribed dose was higher than that of conventional drugs).The liver function before and after the use of hepatoprotective drugs was evaluated by serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL).Results Among the 13 selected hepatoprotective drugs,there were 3 drugs with DUI>1,8 drugs with DUI<1 and 2 drugs with DUI=1 in control group,while 10 drugs with DUI=1 and 3 drugs with DUI<1 in intervention group,which was superior to control group(P<0.05).When compared to control group,the levels of serum ALT,AST and TBIL in intervention group were significantly improved after treatment relative to before treatment(P<0.05).Conclusion Hepatoprotective drugs selected by clinical pharmacists-guided DUR combined with DUE may protect liver function of patients with malignant tumor undergoing chemotherapy.

关 键 词：药物利用评价 药物利用评估 药物利用指数 限定日剂量 用药频度 恶性肿瘤 保肝药物 药物性肝损伤 

分 类 号：R975[医药卫生—药品]