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目的了解杭州地区调脂药物的临床应用情况,发现潜在的用药风险。方法对中国药学会《医院处方分析》项目杭州地区的数据进行数据挖掘,使用Microsoft Visual FoxPro 9.0 SP2软件进行数据处理。结果应用调脂药的男性患者数是女性患者数的1.40倍。40岁以下接受调脂药治疗的患者达3.81%,60岁以上老年患者占70.18%。在相互作用方面,氟伐他汀与5种CYP2C9抑制剂和9种CYP2C9底物合用的处方总量占氟伐他汀处方总量的11.7%。辛伐他汀、阿托伐他汀和洛伐他汀与CYP3A4抑制剂(n=10)和CYP3A4底物(n=23)合用的处方总量占这3种他汀处方总量的51.7%,有潜在的相互作用的风险。调脂药物在心内科应用最广。他汀类药物在神经内科和内分泌科也有较多应用。在各类调脂药物中,他汀类药物占80.0%,苯氧酸类13.4%,烟酸类4.8%,抗氧化剂0.35%,多烯脂肪酸类0.30%。他汀类中阿托伐他汀钙、辛伐他汀、普伐他汀和氟伐他汀的处方量份额分别为50.6%、27.3%、10.9%和11.1%。结论临床已开始重视强化降脂治疗,他汀类的非降脂作用使得该类药物临床应用越来越广。老年患者往往患多种疾病,接受多重药物治疗,因此要充分重视调脂药与其他药理和治疗类别药物的相互作用。注意潜在相互作用带来的安全性改变,有必要做好用药教育和疗程中的药物治疗监测。
Objective To understand the clinical application of lipid-lowering drugs in Hangzhou and to find potential drug risks. Methods The data from Hangzhou area of “Hospital Prescription Analysis” project of Chinese Pharmaceutical Association were collected and the data were processed by Microsoft Visual FoxPro 9.0 SP2 software. Results The number of male patients using lipid-lowering drugs is 1.40 times the number of female patients. Patients under 40 years old receiving lipid-lowering drugs reached 3.81%, 70.18% of elderly patients over the age of 60. In terms of interaction, fluvastatin combined with 5 CYP2C9 inhibitors and 9 CYP2C9 substrates accounted for 11.7% of total fluvastatin formulations. The combined prescriptions of simvastatin, atorvastatin and lovastatin with CYP3A4 inhibitors (n = 10) and CYP3A4 substrates (n = 23) accounted for 51.7% of the total of the three statin prescriptions, with potential The risk of interaction. Lipid-lowering drugs are the most widely used in cardiology. Statins also have more applications in neurology and endocrinology. Of the various lipid-lowering drugs, statins accounted for 80.0%, phenoxy acids 13.4%, nicotinic acid 4.8%, antioxidants 0.35%, polyene fatty acids 0.30%. Prescriptions of atorvastatin calcium, simvastatin, pravastatin and fluvastatin in statins were 50.6%, 27.3%, 10.9% and 11.1%, respectively. Conclusion Clinical emphasis has been placed on lipid-lowering therapy. The non-lipid-lowering effects of statins make the clinical application of these drugs more and more widely. Elderly patients are often suffering from multiple diseases, receiving multiple drug treatment, so full attention to lipid-lowering drugs and other pharmacological and therapeutic categories of drug interactions. Pay attention to the safety changes brought about by the potential interaction. It is necessary to do the medication education and medication monitoring in the course of treatment.