PCNE分类系统用于侵袭性真菌感染治疗效果评价  

PCNE Classification System for Evaluating the Therapeutic Effect of Invasive Fungal Infections

作　　者：张文 王琳 唐炯 崔建蓉[2] 王飞 ZHANG Wen;WANG Lin;TANG Jiong;CUI Jianrong;WANG Fei(Sichuan Provincial Women's and Children's Hospital·The Affiliated Women's and Children's Hospital of Chengdu Medical College,Chengdu,Sichuan,China 610031;Chengdu Seventh People's Hospital,Chengdu,Sichuan,China 610200)

机构地区：[1]四川省妇女儿童医院·成都医学院附属妇女儿童医院,四川成都610031 [2]四川省成都市第七人民医院,四川成都610200

出　　处：《中国药业》2025年第6期25-30,共6页China Pharmaceuticals

基　　金：四川省成都市医学科研课题[2023573]。

摘　　要：目的探讨欧洲医药保健网(PCNE)分类系统用于侵袭性真菌感染治疗的效果。方法选取医院呼吸与危重症医学科及肿瘤科2023年7月1日至2024年6月30日收治的使用侵袭性真菌感染药物治疗的住院患者285例,按随机数字表法分为对照组(141例)和观察组(143例),两组均接受传统医疗服务,临床药师另基于PCNE分类系统并结合相应指南、原则对观察组患者开展监护,包括信息收集及梳理、完善检查并评估、问题归因及干预、定期随访并记录,分析并评价发现的药物相关问题(DRP)的数量、问题类型、原因、干预类型、干预方案的接受及状态,比较两组患者的临床结局。结果两组患者选用抗真菌药物频率最高的均为氟康唑,其次是伏立康唑;用药目的均以经验性治疗为主。观察组共发现DRP 115个,治疗有效性问题69个(60.00%),治疗安全性问题16个(13.91%)。130个DRP原因可分为7大项、16小项,以药物选择和剂量选择两方面为主。DRP干预类型主要是针对医师层面(94个,81.74%),接受度高达94.78%,66.09%的DRP得到解决。观察组治疗有效率为81.94%,明显高于对照组的65.96%(P<0.05)。观察组与对照组不良反应发生率相当(7.64%比3.55%,χ^(2)=2.252,P=0.13)。结论临床药师将PCNE分类系统用于侵袭性真菌感染临床药物治疗,可实现DRP的收集、分析、干预及解决与评价;继而通过开展针对性的药学干预提升该类疾病的治疗效果。Objective To explore the application of the Pharmaceutical Care Network Europe(PCNE)classification system in evaluating the therapeutic effects of invasive fungal infection treatments.Methods A total of 285 inpatients who received antifungal therapy in the Department of Respiratory and Critical Care Medicine and the Department of Oncology between July 1,2023,and June 30,2024,were selected.They were randomly divided into a control group(141 cases)and an observation group(143 cases).Both groups received conventional medical services,while clinical pharmacists additionally applied the PCNE classification system in the observation group,integrating relevant guidelines and principles for monitoring.This included data collection and analysis,examination and evaluation,identifying causes and interventions,periodic follow-ups,and documentation.The number,types,causes,interventions,acceptance,and resolution status of drug-related problems(DRPs)were analyzed,and the clinical outcomes of the two groups were compared.Results Fluconazole was the most frequently used antifungal drug in both groups,followed by voriconazole,with empirical treatment being the primary therapeutic purpose.A total of 115 DRPs were identified in the observation group,including 69(60.00%)issues related to treatment efficacy and 16(13.91%)concerning treatment safety.The 130 identified DRP causes were categorized into seven major categories and 16 subcategories,primarily involving drug selection and dosage selection.The primary type of DRP intervention targeted physicians(94 cases,81.74%),with an acceptance rate of 94.78%,leading to the resolution of 66.09%of DRPs.The therapeutic effectiveness rate in the observation group was 81.94%,significantly higher than the 65.96%in the control group(P<0.05).The incidence of adverse reactions was comparable between the observation and control groups(7.64%vs.3.55%,χ^(2)=2.252,P=0.13).Conclusion The application of the PCNE classification system by clinical pharmacists in the pharmacotherapy of invasive fungal infec

关 键 词：欧洲医药保健网 分类系统 药学监护 侵袭性真菌感染 

分 类 号：R95[医药卫生—药学]