我院常规治疗药物监测15年回顾分析

目的:促进治疗药物监测(TDM)工作深入开展,提高临床治疗水平。方法:对我院1989年3月~2004年3月共15年间的常规TDM15 733例有效数据进行回顾性分析,包括主要监测药物品种的构成、总体的监测结果分布情况、其中10年(1993~2002)的监测结果分布情况、监测样本的来源构成情况以及院内外样本监测结果比较。结果:在选择的有效数据中,地高辛测定次数占43.4%,其次为茶碱27.9%;血药浓度在治疗窗内的占45.04%,而低于治疗窗的为47.38%;10年13 345例中,监测例数逐年增加,而监测结果的构成比变化不大;样本主要来源于住院患者,占75.03%,急诊室最少;院外样本占5.4%;院内样本监测结果在治疗窗内的比例略高于院外样本。结论:尽管监测例数不断增加,但监测结果分布在治疗窗内的比例仍然很低,有必要充分利用监测结果主动调整给药方案。

Retrospective Analysis of Conventional Therapeutic Drug Monitoring over the Past 15 Years in Our Hospital

OBJECTIVE: To promote the practice of therapeutic drug monitoring( TDM) and to improve clinical treatment level.METHODS: The valid data of 15 733 cases who underwent conventional TDM in our hospital over the 15 years from Mar.1989 to Mar.2004 were analyzed retrospectively in regard to constituent ratios of drug varieties,overall distribution of drug monitoring results including the distribution of monitoring results over 10 years from 1993～ 2002,constituent ratios of sample resources and the comparison of monitoring results between our hospital and the other hospitals.RESULTS: Among all the selected valid data,the percentage of monitoring times for digoxin was 43.4%,followed by theophyllin(27.9%).Percentage for those whose drug level was within therapeutic window stood at 45.04%,and 47.38% for those whose drug level was lower than therapeutic window.Of the total 13 345 cases over 10 years,the TDM cases increased year by year while the constituent ratios of TDM results showed little difference.75.03% of the samples come from inpatients,but least from the emergency depa_rtment,and 5.4% from other hospital.Samples that from our hospital was a little bit higher than that from other hospitals in regard to percentage of TDM results that within the therapeutic window.CONCLUSIONS: TDM cases keep increasing,yet the percentage of drug monitoring results that within therapeutic window remains very low,attention should be paid to which in the clinic and the dosage regimen should be adjusted in time according to TDM results.