维持性血液透析患者口服药物应用现状分析  

Analysis of the current situation of oral medications use in maintenance hemodialysis patients

作　　者：孙福州 王誉芳 姜晓凤[1] 周长学[1] 李锋[1] 宋慧 SUN Fuzhou;WANG Yufang;JIANG Xiaofeng;ZHOU Changxue;LI Feng;SONG Hui(Department of Nephrology,Zaozhuang Municipal Hospital,Shandong Province,Zaozhuang 277100,China;Depart ment of Pharmacy,Zaozhuang Municipal Hospital,Shandong Province,Zaozhuang 277100,China)

机构地区：[1]山东省枣庄市立医院肾内科,山东枣庄277100 [2]山东省枣庄市立医院药学科,山东枣庄277100

出　　处：《中国当代医药》2025年第9期120-124,共5页China Modern Medicine

摘　　要：目的探讨维持性血液透析患者口服药物负担的现状,为临床制订个体化药物治疗提供依据。方法采用横断面调查的方法收集2024年8月枣庄市立医院211例接受规律血液透析患者的口服药物信息和处方。记录患者的基本信息和所有口服药物的名称、频次及剂量。结果患者平均每日服用药片数为9.5片,每周总计约66.5片,所使用的药物种类数的中位数为6种。铁剂、钙通道阻滞剂(CCB)、沙库巴曲缬沙坦、降磷药物和钙剂是使用率最高的药物。低龄组患者β受体阻滞剂用药率高于高龄组,心脏用药和中成药使用率低于高龄组,差异有统计学意义(P<0.05)。非糖尿病患者降糖药、CCB类降压药、抗血小板药物、他汀类的用药率低于糖尿病组,差异有统计学意义(P<0.05)。不同年龄组和是否患有糖尿病患者的每周服用药物总数的比较,差异无统计学意义(P>0.05)。此外,维持性血液透析患者口服药物不合理处方比例达12.32%,主要表现为药物间不良相互作用、药品选择不当及用法用量不适宜。结论维持性血液透析患者面临较高的药物负担,且存在一定的不合理处方现象。针对不同年龄段及糖尿病状态下的个体化药物管理策略对于减轻药物负担、提高治疗安全性和有效性至关重要。Objective To investigate the current situation of oral medications in maintenance hemodialysis patients,and to provide evidence for clinical formulation of individualized drug therapy.Methods The information and prescription of oral medications were collected from 211 patients receiving regular hemodialysis in Zaozhuang Municipal Hospital in August 2024 by cross-sectional investigation.Basic patient information and the name,frequency,and dosage of all oral medications were recorded.Results Patients took an average of 9.5 tablets per day and a total of 66.5 tablets per week.The median num-ber of drugs used was 6.Iron,calcium channel blockers(CCB),sacubactril valsartan,phosphorus-reducing drugs and calcium were the most frequently used medication.The use rate ofβ-blocker in the younger group was higher than that in the older group,and the use rate of cardiac drugs and proprietary Chinese medicines were lower than those in the older group,with statistical significances(P<0.05).The use rates of hypoglycemic drugs,CCB antihypertensive drugs,antiplatelet drugs and statins in non-diabetic patients were lower than those in diabetic group,and the differences were statistically significant(P<0.05).There were no significant differences in the total number of weekly drugs taken by different age groups and patients with or without diabetes(P>0.05).In addition,the proportion of irrational oral medications prescription in maintenance hemodialysis patients was 12.32%,which was mainly characterized by adverse drug interaction,improper drug selection and inappropriate usage and dosage.Conclusion Maintenance hemodialysis patients are faced with high drug bur-den,and there is some irrational prescription phenomenon.Individualized drug management strategies for different age groups and diabetic states are essential to reduce drug burden and improve treatment safety and effectiveness.

关 键 词：维持性血液透析 口服药物 药物负担 不合理处方 

分 类 号：R459[医药卫生—治疗学]