非瓣膜性房颤患者应用新型口服抗凝药的药物相关问题调查  

Investigation on drug-related problems of using novel oral anticoagulants in patients with non-valvular atrial fibrillation

作　　者：陈晓坚 袁雪莹 何春缓 谢思丽 CHEN Xiaojian;YUAN Xueying;HE Chunhuan;XIE Sili(Department of Pharmacy,Lian Jiang People’s Hospital,Guangdong,Lianjiang 524400,China)

机构地区：[1]广东省廉江市人民医院药学部,广东廉江524400

出　　处：《中国医药科学》2025年第7期78-81,共4页China Medicine And Pharmacy

基　　金：广东省湛江市科技计划项目(2023B01224)。

摘　　要：目的调查非瓣膜性房颤(NVAF)患者新型口服抗凝药(NOACs)的使用情况,为临床合理用药提供参考。方法筛选廉江市人民医院心血管内科2023年1—12月诊断为NVAF并使用NOACs的病例,参考各药品说明书以及相关指南共识,审查患者使用NOACs的适宜性,并结合Granada-Ⅱ分类法对NVAF患者应用NOACs进行药物相关问题(DRPs)分析。结果241例NVAF患者使用了NOACs,102例涉及DRPs。其中DRP4发生率最高,占58.82%,主要表现在NOACs剂量过少;DRP5次之,占20.59%,主要表现在禁忌用药。不同年龄段以及肾功能差异患者中DRPs的发生情况不同,差异有统计学意义(P<0.05)。结论NVAF患者使用NOACs过程中以剂量过少以及禁忌用药情况最为突出。临床医生疏忽年龄或肾功能情况可能是发生DRPs的原因。临床需强化相关知识学习以促进NOACs的合理使用。Objective To investigate the use of novel oral anticoagulants(NOACs)in patients with non-valvular atrial fibrillation(NVAF),and to provide reference for rational medication in clinical practice.Methods Cases diagnosed with the use of NOACs admitted to the Department of Cardiovascular in Lian Jiang People’s Hospital from January to December 2023 were selected,various drug instructions and relevant guidelines were referred to,the suitability of patients’use of NOACs was reviewed,and drug-related problems(DRPs)related to the use of NOACs in patients with NVAF combined with the Granada-Ⅱclassification system were analyzed.Results A total of 241 patients with NVAF were treated with NOACs,and 102 patients were involved with DRPs.In them,DRP4 had the highest incidence rate,accounting for 58.82%,mainly manifested by insufficient NOACs dosage.DRP5 ranked secondly,accounting for 20.59%,mainly manifested by contraindications.The occurrence of DRPs varied in patients of different age groups and renal functions,with statistically significant differences(P<0.05).Conclusion In the process of using NOACs in patients with NVAF,the most prominent situations are insufficient dosage and contraindications to medication.Neglecting age or renal function may be the cause of DRPs in clinical practice,which needs to strengthen the learning of relevant kn owledge to promote the rational use of NOACs.

关 键 词：非瓣膜性房颤 新型口服抗凝药 药物相关问题 Granada-Ⅱ分类法 

分 类 号：R973.2[医药卫生—药品]