5种神经保护剂在急性缺血性卒中治疗中的应用现状与处方趋势分析  

Analysis of the application status and prescription trends of 5 neuroprotective agents in acute ischemic stroke

作　　者：武明芬 官海静 孙阿宁 赵志刚[1] WU Ming-fen;GUAN Hai-jing;SUN A-ning;ZHAO Zhi-gang(Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院药学部,北京100070

出　　处：《临床药物治疗杂志》2024年第4期32-40,共9页Clinical Medication Journal

基　　金：北京市教委科研计划(KM202010025017);北京药学会临床药学研究项目(LCYX-2022-02)。

摘　　要：目的分析我国用于改善急性缺血性卒中(AIS)患者神经功能的5种神经保护剂的应用现状与处方趋势。方法从医院处方分析合作项目数据库中提取2016—2022年诊断为AIS的处方,收集患者的性别、年龄、城市类型、处方时间、就诊科室、原始诊断、药品名称、用法用量、药品日均费用、支付方式等特征,分析5种神经保护剂的使用现状与处方趋势,探讨其使用的合理性。结果共纳入1064264张处方,其中依达拉奉575490张,依达拉奉右莰醇42826张,尤瑞克林75023张,丁苯酞285230张,马来酸桂哌齐特85695张。男性患者居多(63.08%),中位年龄66岁,三级医院处方占95.59%,86.81%的患者来自住院病房。依达拉奉右莰醇的日均费用最高,为292.80元;尤瑞克林的日均费用最低,为100.00元。依达拉奉和马来酸桂哌齐特的处方数量逐年降低,尤瑞克林、丁苯酞和依达拉奉右莰醇的处方数量逐年增加。联合用药处方118676张(11.15%),三药及四药联用处方5819张(0.55%)。结论神经保护剂在AIS中的应用呈逐年下降趋势,丁苯酞、尤瑞克林和依达拉奉右莰醇是目前使用较多的神经保护剂,还存在多种药物联用的不合理情况,临床应重点关注。Objective To analyze the current application status and prescription trends of 5 neuroprotective agents for im⁃proving nerve function in patients with acute ischemic stroke(AIS)in China.Methods Prescriptions with the diagnosis of AIS from 2016 to 2022 were extracted from the Hospital Prescription Analysis Cooperation Project(HPACP)database for retrospec⁃tive analysis.Patient characteristics,including gender,age,city type,prescription time,department of visit,original diagno⁃sis,drug name,dosage,drug daily cost,payment method,etc.,were collected to analyze the current usage status and pre⁃scription trends of 5 neuroprotective agents and discuss their rational use.Results A total of 1064264 prescriptions were in⁃cluded in the analysis,and the number of prescriptions for edaravone,edaravone dexborneol,urinary kallidinogenase,bu⁃tylphthalide,and cinepazide maleate were 575490,42826,75023,285230,and 85695,respectively.Most of the pa⁃tients were male(63.08%),and the median age was 66 years old.Prescriptions from tertiary hospitals accounted for 95.59%,and 86.81%of patients were from inpatient wards.The daily drug cost for edaravone dexborneol was the highest(292.80 yuan)and the lowest was 100.00 yuan for urinary kallidinogenase.The number of edaravone and cinepazide male⁃ate prescriptions decreased yearly,while the numbers of butylphthalide,urinary kallidinogenase,and edaravone dexborneol,prescriptions increased yearly.Prescriptions for combined use of neuroprotective agents totaled 118676(11.15%),with 5819(0.55%)involving three or four agents used in combination.Conclusion The use of neuroprotective agents in AIS is decreasing annually.Butylphthalide,urinary kallidinogenase,and edaravone dexborneol are currently the most commonly used neu⁃roprotective agents.There are also irrational cases of combined use of multiple neuroprotective agents,which should be given more attention.

关 键 词：神经保护剂 急性缺血性卒中 依达拉奉右莰醇 尤瑞克林 丁苯酞 马来酸桂哌齐特 

分 类 号：R971[医药卫生—药品]