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复旦大学附属妇产科医院药学部
纸质出版日期:2021,
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孙慧, 王萌萌, 庞艳玉, 等. 2015—2018年北京、上海和广州子宫内膜病变患者治疗药物使用情况分析[J]. 中国医院用药评价与分析, 2021,21(12):1513-1519.
SUN Hui, WANG Mengmeng, PANG Yanyu, et al. Application of Therapeutic Drugs in Patients with Endometrial Disease in Beijing,Shanghai and Guangzhou from 2015 to 2018[J]. 2021,21(12):1513-1519.
孙慧, 王萌萌, 庞艳玉, 等. 2015—2018年北京、上海和广州子宫内膜病变患者治疗药物使用情况分析[J]. 中国医院用药评价与分析, 2021,21(12):1513-1519. DOI: 10.14009/j.issn.1672-2124.2021.12.021.
SUN Hui, WANG Mengmeng, PANG Yanyu, et al. Application of Therapeutic Drugs in Patients with Endometrial Disease in Beijing,Shanghai and Guangzhou from 2015 to 2018[J]. 2021,21(12):1513-1519. DOI: 10.14009/j.issn.1672-2124.2021.12.021.
目的:了解北京、上海和广州3个城市子宫内膜病变治疗药物的使用情况及趋势
评价用药合理性。方法:自《医院处方分析合作项目》数据库中
提取2015—2018年北京、上海和广州子宫内膜病变患者药物治疗的处方数据
对治疗药物的用药频度(defined daily dose system
DDDs)和限定日费用(defined daily cost
DDC)等进行回顾性统计分析。结果:共纳入2015—2018年北京、上海和广州3个城市子宫内膜病变患者21 516张门诊处方和58 203条住院医嘱
其中子宫内膜增生患者予以药物保守治疗的处方(医嘱)共6 556张(份)。孕激素类及促性腺激素类药物使用最多
门诊患者孕激素类及促性腺激素类药物的处方数占比为30.06%(6 468/21 516)、销售金额占比为27.43%(1 158 434.00元/4 223 367.42元)
住院患者孕激素类及促性腺激素类药物的医嘱数占比为0.35%(202份/58 203份)、销售金额占比为0.71%(37 206.70元/5 207 408.43元);其次为口服避孕药、左炔诺孕酮宫内节育系统和促性腺激素释放激素激动剂。口服孕激素中
甲羟孕酮、甲地孕酮、地屈孕酮和黄体酮的DDDs分别为735 600.40、28 090.88、24 127.00和12 857.00
DDC分别为0.70、40.35、24.08和37.42元
且DDDs均呈逐年升高趋势;口服避孕药中
炔雌醇环丙孕酮、屈螺酮炔雌醇和去氧孕烯炔雌醇的使用例次数分别为260、139和61例次
炔雌醇环丙孕酮的使用多于屈螺酮炔雌醇、去氧孕烯炔雌醇; 6 556张(份)子宫内膜增生患者予以药物保守治疗的处方(医嘱)中
单独使用孕激素类及促性腺激素类药物处方(医嘱)共4 909张(份)
占74.88%。结论:门诊是医师为子宫内膜病变患者开具孕激素类及促性腺激素类药物的主要场所
子宫内膜病变处方以孕激素类及促性腺激素类药物单药治疗为主
主要为口服孕激素
其中甲羟孕酮、甲地孕酮、地屈孕酮和黄体酮的使用居多
且具有良好的药物经济性
甲羟孕酮的DDC最低。因此
可通过加强门诊子宫内膜病变患者孕激素类药物的使用规范性和选药经济性
不断提高患者用药的合理性。
OBJECTIVE: To investigate the application and trend of therapeutic drugs in patients with endometrial disease in Beijing
Shanghai and Guangzhou
and to evaluate the application rationality of drugs. METHODS:Prescription data of patients with endometrial disease in Beijing
Shanghai and Guangzhou from 2015 to 2018 were extracted from the hospital prescription analysis cooperation project database
the defined daily dose system( DDDs)and defined daily cost( DDC) were analyzed retrospectively. RESULTS: A total of 21 516 outpatient prescriptions and 58 203 inpatient medical orders were collected form patients with endometrial disease in Beijing
Shanghai and Guangzhou from 2015 to 2018
among which 6 556 prescriptions and medical orders were for conservative treatment of patients with endometrial hyperplasia. Progesterone and gonadotropin drugs were the most used
and the proportion of prescriptions and consumption sum of progesterone and gonadotropin drugs in outpatients were respectively 30. 06%( 6 468/21 516) and 27. 43%( 1 158 434. 00 yuan/4 223 367. 42 yuan)
the proportion of medical orders and consumption sum of progesterone and gonadotropin drugs in inpatients were respectively 0. 35%( 202/58 203) and0. 71%( 37 206. 70 yuan/5 207 408. 43 yuan)
followed by oral contraceptives
levonorgestrel intrauterine birth control system and gonadotropin-releasing hormone agonist. In oral progesterone
DDDs of medroxyprogesterone
medroxyprogesterone
dydrogesterone and progesterone were respectively 735 600. 40
28 090. 88
24 127. 00 and 12 857. 00
and DDC were respectively 0. 70
40. 35
24. 08 and 37. 42 yuan
and the DDDs were in an increasing trend year by year. In oral contraceptives
the number of case-times with ethinylestradiol cyproterone
drospirenone ethinylestradiol and deoxyprogesterone ethinylestradiol were respectively 260
139 and 61
and the application of ethinylestradiol cyproterone was more than that of drospirenone ethinylestradiol and deoxyprogesterone ethinylestradiol.Among 6 556 prescriptions and medical orders for conservative treatment of patients with endometrial hyperplasia
4 909( 74. 88%) were for progesterone and gonadotropin drugs alone. CONCLUSIONS: The outpatient clinic is the main place for clinicians to prescribe progesterone and gonadotropin drugs for patients with endometrial hyperplasia.Prescriptions for endometrial disease are mainly progesterone and gonadotropin drugs for monotherapy
mainly oral progesterone
of which medroxyprogesterone
megestrol
dydrogesterone and progesterone are mostly used with good drug economy
medroxyprogesterone has the lowest DDC. Therefore
by strengthening the standardization of application of progesterone and the economy of drug selection for patients with endometrial disease in outpatients
the rationality of patients’ medication can be continuously improved.
子宫内膜增生孕激素口服避孕药促性腺激素释放激素激动剂
Endometrial hyperplasiaProgestational hormoneOral contraceptiveGonadotropin-releasing hormone agonist
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