目的 分析国内糖尿病视网膜病变患者的临床用药现状,为临床合理用药提供参考。方法 采用分层抽样与整体抽样相结合的二阶抽样方式,对《医院处方分析合作项目》中全国9个地区的135家医院2018年门诊、急诊和病房糖尿病视网膜病变用药相关数据进行统计分析。结果 2018年135家医院共使用糖尿病视网膜病变药物17种,使用比例最高的科室为内分泌科,其次为眼科。门诊用药占比73.2%。处方量排名前三位的药物羟苯磺酸钙、甲钴胺及胰激肽原酶占所有17种药物总处方量的81.8%,但除羟苯磺酸钙外,多无充分的循证医学证据,且多为超适应证使用。结论 糖尿病视网膜病变临床用药的规范性有待进一步提高。
Abstract
OBJECTIVE To analyse current situation of clinical drug use in diabetic retinopathy and provide reference for clinical rational drug use. METHODS Two-stage sampling method was adopted which combines stratified sampling and holistic sampling, and conducted statistical analysis was conducted of with the clinical medication related data of diabetic retinopathy in 2018, which including 135 hospitals in 9 cities in “the cooperation project of hospital prescription analysis”. RESULTS Seventeen Drugs for diabetic retinopathy were used in 135 hospitals in 2018, endocrinology contributed the most, and followed by ophthalmology, and outpatients accounted for 73.2%. The top 3 most frequently used drugs for diabetic retinopathy are calcium dobesilate, mecobalamin and pancreatic kininogenase, which accounted for 81.8% of the total 17 drugs prescription volume. It is lack of evidence for most drugs except for calcium dobesilate, and off-label use of DR drugs is common. CONCLUSION The standardization of clinical medication for diabetic retinopathy needs to be further improved.
关键词
糖尿病视网膜病变 /
用药分析 /
合理用药
{{custom_keyword}} /
Key words
diabetic retinopathy /
medication analysis /
rational drug use
{{custom_keyword}} /
中图分类号：
R969
{{custom_clc.code}}
({{custom_clc.text}})
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Chinese Diabetes Society. Chinese practice guidelines of type 2 diabetes (2017) . Chin J Diabetes Mel(中华糖尿病杂志), 2018,10(1):4-67.
[2] LIU L, WU X, LIU L, et al. Prevalence of diabetic retinopathy in mainland China: a Meta-analysis. PLoS One, 2012, 7(9):e45264.
[3] LIU Y, SONG Y, TAO L, et al. Prevalence of diabetic retinopathy among 13473 patients with diabetes mellitus in China: a cross-sectional epidemiological survey in six provinces. BMJ Open, 2017, 7(1):e013199.
[4] ZHANG G, CHEN H, CHEN W, et al. Prevalence and risk factors for diabetic retinopathy in China: multi-hospital-based cross-sectional study. Br J Ophthalmol, 2017, 101(12):1591-1595.
[5] Chinese Association of Diabetes and Microcirculation. Microcirculation dysfunction in diabetes: Chinese experts consensus statement . Chin J Front Med Sci (Elec)(中国医学前沿杂志电子版), 2017, 9(2):34-41.
[6] American Academy of Ophthalmology Retina/Vitreous Panel. Diabetic Retinopathy Preferred Practice Pattern® Guidelines-updated 2017. [EB/OL]. San Francisco, CA: American Academy of Ophthalmology, 2017. [2019-08-02] https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017.
[7] ZHANG R, LI Y, ZHANG S, et al. The association of retinopathy and plasma glucose and HbA1c: a validation of diabetes diagnostic criteria in a Chinese population . J Diabetes Res, 2016:4034129.
[8] Chinese Diabetes Society Diabetic Retinopathy Group. China consensus on the management of diabetic retinopathy . Chin J Diabetes Mel(中华糖尿病杂志),2018,10(4):241-247.
[9] RIBEIRO M L, SERES A I, CAMEIRO A M, et al. Effect of calcium dobesilate on progression of early diabetic retinopathy: a randomised double-blind study . Graefes Arch Clin Exp Ophthalmol, 2006, 244(12):1591-1600.
[10] ZHANG X, LIU W, WU S, et al. Calcium dobesilate for diabetic retinopathy: a systematic review and Meta-analysis . Sci China Life Sci(中国科学:生命科学), 2015, 58(1):101-107.
[11] ZHANG H W, ZHANG H, GRANT S J, et al. Single herbal medicine for diabetic retinopathy . Cochrane Database Syst Rev, 2018, 12: CD007939.
{{custom_fnGroup.title_cn}}
脚注
{{custom_fn.content}}
基金
首都卫生发展科研专项项目资助(首发2018-3-4017)
{{custom_fund}}
PDF(1420 KB)
