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某“三甲”医院2014－2016年乳腺癌患者术后内分泌治疗药物的应用分析
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| 篇名： | 某“三甲”医院2014－2016年乳腺癌患者术后内分泌治疗药物的应用分析 |
| TITLE： | |
| 摘要： | 目的：了解乳腺癌术后内分泌治疗药物的应用状况及发展趋势，为促进临床合理用药提供参考。方法：采用回顾性研究方法，对2014－2016年在某“三甲”医院接受乳腺癌术后内分泌治疗的门诊患者的相关用药数据进行统计、计算、排序及分析。结果：接受乳腺癌术后内分泌治疗的门诊患者年龄多集中在＞40～60岁。3年间使用的内分泌治疗药物品种属于芳香化酶抑制剂（AI）的有3种，属于抗雌激素类的有3种，属于促性腺激素释放激素（GnRH）类似物的有2种。枸橼酸托瑞米芬片（进口）的处方量远大于其他品种；抗雌激素类单独用药的处方量比例最高（81.11％），AI和GnRH类似物则以联合用药处方居多，并常与抗骨质疏松药物联用。内分泌治疗药物的使用金额逐年上升，2015、2016年的增长率分别为52.48％、40.60％；3类药物中AI的使用金额占比最高（3年间分别为44.71％、48.62％、48.62％）；进口药品使用金额占比明显高于国产药品，枸橼酸托瑞米芬片（进口）3年间使用金额持续增长，到2016年已居首位，而注射用醋酸亮丙瑞林微球（进口）应用于临床后使用金额增长幅度最大。DDC排序靠前的皆为进口品种，其中最高的是氟维司群注射液（进口），而排最后的是枸橼酸他莫昔芬片（国产）。内分泌治疗药物的DDDs亦呈逐年上升趋势，其中枸橼酸托瑞米芬片、枸橼酸他莫昔芬片、来曲唑片和阿那曲唑片的DDDs排序3年间始终居前4位，但枸橼酸他莫昔芬片的DDDs逐年下降。各品种的B/A值介于0.25～9.00之间；国产品种的B/A值基本≥1，其中枸橼酸他莫昔芬片（国产）的B/A值最大；而进口品种的B/A值基本≤1。结论：3年间该院乳腺癌术后内分泌治疗药物的使用金额逐年增加，DDDs亦呈逐年上升趋势，进口药品的使用占主导；枸橼酸托瑞米芬片已取代枸橼酸他莫昔芬片成为首选的内分泌治疗药物；AI和GnRH类似物日益受到临床的青睐；两类内分泌治疗药物联用以及内分泌治疗药物与抗骨质疏松药物联用在临床中越来越多见。该类药物的选择应兼顾有效性、安全性和经济性因素，综合分析成本及疗效，以保障患者的最大获益。 |
| ABSTRACT： | OBJECTIVE： To investigate the utilization and trend of endocrine therapeutic drugs after breast cancer surgery， and to provide reference for rational drug use in clinic. METHODS： In retrospective study， the data of endocrine therapeutic drugs use in outpatients after breast cancer in a Third Grade Class A Hospital during 2014-2016 was calculated， sorted and analyzed statistically. RESULTS： The age of outpatients receiving endocrine therapy after breast cancer ranged from ＞40 to 60. Among endocrine therapeutic drugs used within 3 years， 3 kinds of them were aromatase inhibitor （AI）， 3 kinds were anti-estrogen and 2 kinds were gonadotropin releasing hormone （GnRH） analogues. The amount of Toremifene citrate tablets （imported） in prescription was much more than the others. The proportion of anti-estrogen drugs alone in prescription was the highest （81.11％）. The AI and GnRH analogues were mostly used in drug combination prescription， and commonly combined with anti-osteoporosis drugs. The comsuption sum of endocrine therapeutic drugs was increased year by year， increasing by 52.48％ in 2015， 40.60％ in 2016. The consumption sum of AI ranked the highest proportion among three categories of endocrine drugs （44.71％， 48.62％， 48.62％， each year respectively）. The consumption sum of imported drugs was significantly higher than that of domestic drugs. The consumption sum of Toremifene citrate tablets （imported） increased continuously in 3 years， and took the first place in 2016. The consumption sum of Leuprorelin acetate microspheres for injection （imported） had the largest growth rate when applied to the clinic. Top types in the list of DDC were all imported types； Fulvestrant injection （imported） ranked top 1， and Tamoxifen citrate tablet （domestic） was the bottom of the list. DDDs of endocrine therapeutic drugs also increased year by year， among which Toremifene citrate tablets， Tamoxifen citrate tablets， Anastrozole tablets and Letrozol tablets ranked top 4 places during the 3 years， while Tamoxifen citrate tablets DDDs decreased year by year. B/A values of these drugs were between 0.25 and 9.00. B/A values of domestic varieties were basically more than or equal to 1， of which Tamoxifen citrate tablets was the largest； B/A values of the imported varieties were basically less than or equal to 1. CONCLUSIONS： The consumption sum of endocrine therapeutic drugs after breast cancer surgery increased year by year in 3 years， and DDDs is also increasing year by year. The imported drugs took up the dominant place. Toromiphene citrate tablets had replaced Tamoxifen citrate tablets as the first choice of endocrine therapeutic drugs in the hospital. The frequency of AI and GnRH analogues use had also increased. And the combination of 2 kinds of endocrine therapeutic drugs and endocrine therapeutic drugs combined with anti-osteoporosis drug had become a trend of clinical treatment. The choice of therapeutic drugs should take into account of effectiveness， safety， economics， cost and therapeutic efficacy， so as to guarantee the greatest benefit of the patient. |
| 期刊： | 2018年第29卷第12期 |
| 作者： | 方瑞，肖大立，陈泺，王铁桥，王穗琼 |
| AUTHORS： | FANG Rui，XIAO Dali，CHEN Luo，WANG Tieqiao，WANG Suiqiong |
| 关键字： | 乳腺癌；内分泌治疗药物；用药分析；使用金额；用药频度；日均费用 |
| KEYWORDS： | Breast cancer； Endocrine therapeutic drug； Drug utilization analysis； Consumption sum； DDDs； DDC |
| 阅读数： | 286 次 |
| 本月下载数： | 8 次 |
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