基于AHM赋权联合TOPSIS法的西妥昔单抗注射液用药合理性评价  

Evaluation of the Rationality of Cetuximab Injection Use Based on AHM Weighting Combined with TOPSIS Method

作　　者：梁国栋 张威峰 葛明明 范娟 LIANG Guodong;ZHANG Weifeng;GE Mingming;FAN Juan(Department of Pharmacy,Fuyang Cancer Hospital,Fuyang,Anhui,China 236000)

机构地区：[1]安徽省阜阳市肿瘤医院药剂科,安徽阜阳236000

出　　处：《中国药业》2025年第4期32-36,共5页China Pharmaceuticals

基　　金：安徽省阜阳市“十四五”临床重点专科建设项目[阜卫医函[2023]41号]。

摘　　要：目的 为临床合理使用西妥昔单抗注射液提供参考。方法 以西妥昔单抗注射液药品说明书为基础,并以其国内外诊疗指南为依据,结合中国知网、万方、维普、美国国立综合癌症网络(NCCN)、Pub Med数据库等相关文献及医院临床用药实际情况,制订该药的药物利用评价(DUE)标准。通过医院信息系统(HIS)随机抽取2021年10月至2023年10月以西妥昔单抗注射液治疗的住院患者病历239份,基于属性层次模型(AHM)赋权法联合优劣解距离(TOPSIS)法计算相对接近程度(Ci),评价患者用药合理性。结果 共设定11个评价指标,分别为体力状况、适应证、用法用量、配伍禁忌、注意事项、禁忌证、联合用药、临床疗效评价、不良反应监测与处理、用药监护、医师权限,权重值分别为6.468%,13.930%,16.418%,5.970%,9.950%,3.980%,7.463%,10.448%,9.453%,12.935%,2.985%。239份病例的Ci介于38%~100%,其中≥80%(合理)161例(67.36%),60%~<80%(基本合理)55例(23.01%),<60%(不合理)23例(9.62%);不合理用药主要集中在用法用量、适应证、不良反应监测与处理等方面。结论 AHM赋权联合TOPSIS法能很好地反映西妥昔单抗注射液用药合理性,且结果直观、准确,可为优化其临床用药提供借鉴。Objective To provide a reference for the rational use of Cetuximab Injection in clinical practice.Methods Based on the drug instruction of Cetuximab Injection and its domestic and international diagnostic and treatment guidelines,the drug utilization evaluation(DUE)criteria for this drug were formulated according to relevant literature in the CNKI,WanFang,VIP,National Comprehensive Cancer Network(NCCN),PubMed databases and the actual clinical use of drugs in the hospital.A total of 239 medical records of inpatients treated with Cetuximab Injection from October 2021 to October 2023 were randomly selected from the Hospital Information System(HIS).The relative closeness(Ci)was calculated based on the attribute hierarchy model(AHM)weighting method combined with the technique for order preference by similarity to an ideal solution(TOPSIS)method to evaluate the medication rationality of patients.Results A total of 11 evaluation indicators were set,including physical condition,indications,usage and dosage,compatibility contraindications,precautions,contraindications,combined medication,clinical efficacy evaluation,adverse reaction monitoring and management,medication monitoring,and physicians'authority,with weights of 6.468%,13.930%,16.418%,5.970%,9.950%,3.980%,7.463%,10.448%,9.453%,12.935%,and 2.985%,respectively.The Ci of 239 cases was in the range of 38%to 100%,with 61 cases(67.36%)having a Ci of≥80%(rational),55 cases(23.01%)having a Ci of 60%to<80%(basically rational),and 23 cases(9.62%)having a Ci of<60%(irrational);irrational drug use mainly focused on usage,dosage,indications,monitoring and management of adverse reactions.Conclusion Based on AHM weighting combined with TOPSIS method,the rationality of Cetuximab Injection use can be reflected intuitively and accurately,which can provide a reference for optimizing its clinical use.

关 键 词：属性层次模型赋权法 优劣解距离法 西妥昔单抗注射液 药物利用评价 合理用药 

分 类 号：R969.3[医药卫生—药理学]