• 1. 解放軍總醫(yī)院,北京,1008532. 解放軍小湯山醫(yī)院,北京,1000003. 四川大學華西醫(yī)院中國循證醫(yī)學中心,成都,610041;

目的 　調(diào)查分析小湯山醫(yī)院680例臨床確診SARS患者治療期間的藥物利用情況.
方法 　采用HIS系統(tǒng)回顧性分析小湯山醫(yī)院臨床確診的680例SARS患者的病案及用藥記錄,分別運用計算機病例分型模型(A、B、C、D型)和臨床分型模型(普通型、重癥型)分組,統(tǒng)一采用合理用藥指標:限定成人日劑量(defined daily dose, DDD)、藥物利用指數(shù)(drug utilization index, DUI)、用藥例次數(shù)、醫(yī)囑數(shù)及人均藥費、日均藥費等,評價各組間的差異.
結(jié)果 　680例SARS患者共計應用17大類359種藥物,應用病例數(shù)最多的是抗菌藥物.應用經(jīng)費最多的是糖皮質(zhì)激素和大輸液類藥物.DDDs排序最高的為免疫調(diào)節(jié)劑和維生素藥物.應用總天數(shù)最多的是大輸液和維生素類藥物.藥費最高的是甲基強的松龍注射劑.C型、D型和重癥型SARS患者的年齡、死亡率、用藥品種、用藥頻次及經(jīng)費均顯著高于A型和普通型SARS患者.
結(jié)論 　按WHO推薦的合理用藥指標DUI＝1標準,359種藥物中DUI小于、等于和大于1的比例分別為37%、30%和33%.抗病毒藥用量不足,激素類用量過大.計算機病例分型客觀真實、速度快、易標化,具有推廣潛質(zhì).

引用本文： 王睿,周筱青,董軍,魏榮,曹秀堂,周亞春,王瑾,郭代紅,陳騉,周踐,王潔松,朱秀美,梁蓓蓓,徐艷萍,周先志,李幼平,孫鑫,熊鷹. 小湯山醫(yī)院680例SARS患者藥物利用分析. 中國循證醫(yī)學雜志, 2004, 04(7): 474-481. doi: 復制

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  2. 2. ［2］Dong J,Cao XT,Liu ZM,Xu HM,Li YP,Sun X,Wang L,Zhou YC.Computerized classification study on 680 clinical confirmed SARS patients in Xiao Tang Shan Hospital [J].Chinese Journal of Evidence-Based Medicine,2004; 4(5):325-332.
  3. 3. 董軍,曹秀堂,劉志敏,許紅民,李幼平,孫鑫,王莉,周亞春.小湯山醫(yī)院680例SARS臨床確診病例的計算機分型研究 [J].中國循證醫(yī)學雜志,2004; 4(5):325～332.
  4. 4. ［3］Diagnosis standard of SARS.2003傳染性非典型肺炎診斷標準(試行).2003.
  5. 5. ［4］Zou H,Shao YF,Zhu CJ,Deng YL,Ma YJ,Chen SX.Principle and utilization of DDDs analyze in hospital [J].China Dispensary,1996; 7(5):215-217.
  6. 6. 鄒豪,邵元福,朱才娟,鄧渝林,馬玉杰,陳盛新.醫(yī)院藥品DDD數(shù)排序分析的原理及利用 [J].中國藥房,1996; 7 (5):215～217.
  7. 7. ［5］ATC/DDD Index 2003.Availabe from:URL:http://www.whocc.no/atcddd/indexdatabase/.
  8. 8. ［6］Chen XQ.New pharmacology [M].15th ed.Beijing,People’s Publishing House,2003.P.564company.
  9. 9. 陳新謙主編.新編藥物學 [M].第15版.北京:人民衛(wèi)生出版社,2003.p.564.
  10. 10. ［7］Interpretation of ADRs supervise software edited by WHO WHO.
  11. 11. 國際藥品不良反應監(jiān)察計算機軟件說明.
  12. 12. ［8］Meng QH.antiviral treatment recommendation of SARS [C].Academic meeting of SARS,20-22.
  13. 13. 孟慶華.傳染性非典型肺炎的抗病毒治療建議 [C].SARS診治學術(shù)論壇,20～22.
  14. 14. ［9］Koren G,King S,Knowles S,Phillips E.Ribavirin in the treatment of SARS:a new trick for an old drug [J] CMAJ,2003; 168:1 289-1 292.
  15. 15. ［10］Holme KV.SARS-associated coronavirus [J].N Engl J Med,2003; 348:1 948-1 951.
  16. 16. ［11］Zhao Z,Zhang F,Xu M,Huang K,Zhong W,Cai W,Yin Z,Huang S,Deng Z,Wei M,Xiong J,Hawkey PM.Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou,PR China [J].J Med Microbiol,2003; 52(8):715-720.