临床药师在冠心病监护病区促进血管紧张素转换酶抑制剂合理使用的成效

目的 提高血管紧张素转换酶抑制剂（ACEI）的使用合理性。方法 临床药师查阅2012年5月—2013年5月本院冠心病监护病区（CCU）所有病例，参照ACEI专家共识、指南以及药品说明书的标准对ACEI的使用合理性进行分析，但不予任何干预。2013年6月—2015年5月，临床药师参照同样标准，对ACEI的使用合理性进行干预。结果 对比干预前后的数据发现，ACEI使用百分比从80.1%提高至98.9%，ACEI起始剂量偏大的百分比由21.4%下降至0.9%，ACEI剂量不足的百分比从4.7%降至0.5%，差异均有统计学意义。结论 临床药师在促进ACEI的使用合理性方面可起主导作用。

Clinical pharmacists in promoting the rational use of angiotensin-converting enzyme inhibitors in the CCU

Objective To improve the rational use of angiotensin-converting enzyme inhibitors (ACEI). Methods Clinical pharmacists reviewed ACEI use for the patients admitted into coronary heart disease care unit (CCU) during May 2012 to May 2013 to analyze the rational use of ACEI according to the expert consensus standards, guidelines and drug instructions of ACEI without any interventions. Clinical pharmacists intervened the irrational use of ACEI based on the same standard from June 2013 to May 2015. Results By comparing the data before and after intervention, it was found that the percentage of ACEI use increased from 80.1% to 98.9%. The percentage of initial ACEI overdose was dropped from 21.4% to 0.9%, and the percentage of under dose was decreased from 4.7% to 0.5%, which was statistically significant. Conclusion Clinical pharmacists can play a leading role in promoting the rational use of ACEI.