基于加权TOPSIS法评价阿替普酶治疗急性缺血性脑卒中的合理性  

Rationality evaluation of alteplase in the treatment of acute ischemic stroke based on weighted TOPSIS method

作　　者：郭思彤[1] 蔡慧雅 苏恒海 张进华 GUO Sitong;CAI Huiya;SU Henghai;ZHANG Jinhua(Department of Pharmacy,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China;Department of Pharmacy,The Second Hospital of Zhangzhou,Zhangzhou 363199,Fujian Province,China;Department of Pharmacy,Fujian Maternity and Child Health Care Hospital,Fuzhou 350001,China)

机构地区：[1]广西壮族自治区人民医院药学部,南宁530000 [2]福建省漳州市第二医院药剂科,福建漳州363199 [3]福建省妇幼保健院药剂科,福州350001

出　　处：《药物流行病学杂志》2024年第6期642-651,共10页Chinese Journal of Pharmacoepidemiology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210684)。

摘　　要：目的建立阿替普酶治疗急性缺血性脑卒中(AIS)药物利用评价(DUE)标准,并采用加权优劣解距离(TOPSIS)法对其使用情况进行评价,为合理使用阿替普酶提供参考。方法参照药品说明书和相关指南文献,结合专家咨询法制订阿替普酶治疗AIS的DUE标准,收集广西壮族自治区人民医院2020年1月—2022年6月使用注射用阿替普酶治疗AIS的住院患者病历,采用基于属性层次模型的加权TOPSIS法进行合理性点评。结果共纳入126份病历,用药方案与最优方案的相对接近程度(C_(i))>0.8(合理)的80例(63.49%),C_(i)介于0.6~0.8(基本合理)的40例(31.75%),C_(i)<0.6(不合理)的6例(4.76%)。不合理用药情况主要为禁忌证(32.54%)、给药剂量(7.14%)和药物转换(7.14%)等方面。结论采用加权TOPSIS法评价阿替普酶治疗AIS的合理性,结果更直观和全面,该院阿替普酶的使用存在一定问题,需要在用药禁忌证、给药剂量等方面加强干预,促进临床合理使用阿替普酶。Objective To establish a drug use evaluation(DUE)criteria for alteplase in the treatment of acute ischemic stroke(AIS),and to evaluate the use of the drug by weighted TOPSIS method,to provide a reference for rational use of alteplase.Methods Based on the drug package insert,relevant guidelines,the DUE criteria for alteplase in the treatment of AIS were developed combined with expert consultation.The weighted TOPSIS method was used to evaluate the rationality of alteplase use in inpatients with AIS in the People's Hospital of Guangxi Zhuang Autonomous Region from January 2020 to June 2022,based on the attribute hierarchy model.Results A total of 126 medical records were included.Among them,80 cases(63.49%)exhibited a high degree of adherence(C_(i)>0.8)between the prescribed drug regimens and the optimal recommendations,which was considered reasonable.Additionally,40 cases(31.75%)fell within the range of 0.6≤C_(i)≤0.8,indicating a basic reasonable adherence,and 6 cases(4.76%)had a C_(i)<0.6,suggesting an unreasonable level of adherence.The irrational use of the drug mainly involved contraindications(32.54%),dosage(7.14%),and drug conversion(7.14%),among other aspects.Conclusion The weighted TOPSIS method is used to evaluate the rationality of alteplase in the treatment of acute ischemic stroke(AIS),and the results are intuitive and comprehensive.There are still problems in the use of alteplase in this hospital,and it is necessary to strengthen intervention to promote rational clinical use of alteplase in terms of contraindication of medication and dosage,etc.

关 键 词：阿替普酶 急性缺血性脑卒中 药物利用评价 加权优劣解距离法 合理用药 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R969[医药卫生—临床医学]