2014—2018年孝感市中心医院胰岛素类药物的使用情况分析
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摘要
目的了解孝感市中心医院胰岛素类药物的使用情况和变化趋势,为促使临床合理用药提供参考。方法通过医院信息系统(HIS)提取2014—2018年孝感市中心医院胰岛素类药物销售金额、使用频度(DDDs)、日均费用(DDC)及排序比(B/A)等进行统计和分析。结果 2014—2018年,共有12种胰岛素类药物供临床使用,胰岛素类药物的销售金额及占降糖药物总销售金额的构成比均呈增长趋势;甘精胰岛素、地特胰岛素、门冬胰岛素、门冬胰岛素(30)、门冬胰岛素(50)、精蛋白生物合成人胰岛素、精蛋白锌重组赖脯胰岛素(25R)和精蛋白锌重组赖脯胰岛素(50R)的销售金额均呈增长趋势,其中甘精胰岛素、地特胰岛素的增长更显著;精蛋白生物合成人胰岛素(30R)、精蛋白生物合成人胰岛素(50R)、精蛋白锌胰岛素的DDDs值较大,甘精胰岛素、地特胰岛素和门冬胰岛素(30)的DDDs值较小,所有胰岛素类药物的DDDs均呈增长趋势,其中甘精胰岛素、地特胰岛素的DDDs值增加最显著;甘精胰岛素、地特胰岛素的DDC值较大,普通胰岛素和精蛋白锌胰岛素的DDC值较小;大部分胰岛素类药物的B/A值在0.50～1.50,但甘精胰岛素和地特胰岛素的B/A值<0.50。结论孝感市中心医院胰岛素类药物的使用基本合理,但个别患者经济负担较重的胰岛素类药物的增长速度过快,需密切关注,确保临床用药更为规范、合理。
Objective To analyze the utilization and tendency of insulin analogue drugs in Xiaogan Center hospital, and in order to provide reference and management for clinical rational use of drugs. Methods The relevant data of utilization of insulin analogue drugs in Xiaogan Center hospital from 2014 to 2018 was selected from Hospital Information Systems(HIS), and drug varieties, sales amount, defined daily doses(DDDs), defined daily cost(DDC), and sorting ratio(B/A) were analyzed statistically. Results From 2014 to 2018, there were 12 insulin analogues for clinical use, and the sales amount of insulin analogues and its composition ratio of total sales of hypoglycemic drugs all showed an increasing trend. The sales amount of insulin glargine, insulin detemir, insulin aspart, insulin aspart(30), insulin aspart(50), protamine biosynthesis human insulin, protamine zinc recombinant insulin lispro(25 R), and protamine zinc recombination insulin(50 R) were all showed an increasing trend, and the growth rate of insulin glargine and insulin detemir were more significant. DDDs of protamine biosynthesis human insulin(30 R), protamine biosynthesis human insulin(50 R), protamine zinc insulin were larger, and DDDs of insulin glargine, insulin detemir, and insulin aspart(30) were lower, but DDDs of all insulin analogues showed an increasing trend, and increased rate of insulin glargine and insulin detemir were the most. DDC of insulin glargine and insulin detemir were larger, and DDC of ordinary insulin and protamine zinc insulin were lower. B/A values of most insulin analogues in the range of 0.50 to 1.50, but B/A values of insulin glargine and insulin detemir were less than 0.50. Conclusion The use of insulin analogues in Xiaogan Central hospital is reasonable on the whole, but individuals insulin analogue with more financial burdens are growing too fast, and close attention should be paid to ensure that used are more reasonable.
Objective To analyze the utilization and tendency of insulin analogue drugs in Xiaogan Center hospital, and in order to provide reference and management for clinical rational use of drugs. Methods The relevant data of utilization of insulin analogue drugs in Xiaogan Center hospital from 2014 to 2018 was selected from Hospital Information Systems(HIS), and drug varieties, sales amount, defined daily doses(DDDs), defined daily cost(DDC), and sorting ratio(B/A) were analyzed statistically. Results From 2014 to 2018, there were 12 insulin analogues for clinical use, and the sales amount of insulin analogues and its composition ratio of total sales of hypoglycemic drugs all showed an increasing trend. The sales amount of insulin glargine, insulin detemir, insulin aspart, insulin aspart(30), insulin aspart(50), protamine biosynthesis human insulin, protamine zinc recombinant insulin lispro(25 R), and protamine zinc recombination insulin(50 R) were all showed an increasing trend, and the growth rate of insulin glargine and insulin detemir were more significant. DDDs of protamine biosynthesis human insulin(30 R), protamine biosynthesis human insulin(50 R), protamine zinc insulin were larger, and DDDs of insulin glargine, insulin detemir, and insulin aspart(30) were lower, but DDDs of all insulin analogues showed an increasing trend, and increased rate of insulin glargine and insulin detemir were the most. DDC of insulin glargine and insulin detemir were larger, and DDC of ordinary insulin and protamine zinc insulin were lower. B/A values of most insulin analogues in the range of 0.50 to 1.50, but B/A values of insulin glargine and insulin detemir were less than 0.50. Conclusion The use of insulin analogues in Xiaogan Central hospital is reasonable on the whole, but individuals insulin analogue with more financial burdens are growing too fast, and close attention should be paid to ensure that used are more reasonable.
引文
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[5]贺星,田红,徐颂,等.糖尿病治疗药物的研究进展[J].现代药物与临床,2009,24(3):129-133.
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[8]陆玉莲,钱铁镛,陈一丁,等.口服降糖药分别联合不同胰岛素类似物治疗血糖控制不佳2型糖尿病的临床研究[J].中国全科医学,2018,21(23):20-24.
[9]明丽娟.医院2010-2012年降糖药物用药情况分析[J].中国医药,2013,8(10):1467-1468.
[10]陈开杰,俞惠翻,房光萃,等.甘精胰岛素对比预混胰岛素治疗2型糖尿病疗效与安全性的Meta分析[J].中国药房,2016,27(3):354-357.
[11]周帆.甘精胰岛素与低精蛋白锌胰岛素对比治疗2型糖尿病的低血糖风险的系统评价[D].南宁:广西医科大学,2013.
[2]陆菊明.中国2型糖尿病防治指南(2013年版)更新要点的解读[J].中国糖尿病杂志,2014,22(10):865-869.
[3]Sharma S,Jyoti K,Sinha R,et al.Protamine coated proliposomes of recombinant human insulin encased in Eudragist S100 coated capsule offered improved peptide delivery and permeation permeation across Caco-2 cells[J].Mater Sci Eng C Mater Biol Appl,2016,67:378-385.
[4]赵伟,冯晓桃,李双蕾,等.基础胰岛素联合口服降糖药替换胰岛素泵治疗2型糖尿病患者的影响因素[J].广东医学,2015,36(2):301-304.
[5]贺星,田红,徐颂,等.糖尿病治疗药物的研究进展[J].现代药物与临床,2009,24(3):129-133.
[6]陈新谦,金有豫,汤光.新编药物学[M].第17版.北京:人民卫生出版社,2011:665-674.
[7]徐成.重组赖脯胰岛素联合重组甘精胰岛素治疗2型糖尿病的疗效及安全性[D].重庆:重庆医科大学,2015.
[8]陆玉莲,钱铁镛,陈一丁,等.口服降糖药分别联合不同胰岛素类似物治疗血糖控制不佳2型糖尿病的临床研究[J].中国全科医学,2018,21(23):20-24.
[9]明丽娟.医院2010-2012年降糖药物用药情况分析[J].中国医药,2013,8(10):1467-1468.
[10]陈开杰,俞惠翻,房光萃,等.甘精胰岛素对比预混胰岛素治疗2型糖尿病疗效与安全性的Meta分析[J].中国药房,2016,27(3):354-357.
[11]周帆.甘精胰岛素与低精蛋白锌胰岛素对比治疗2型糖尿病的低血糖风险的系统评价[D].南宁:广西医科大学,2013.