真实世界醒脑静注射液治疗脑出血临床应用特征分析

该文基于真实世界研究,探索使用醒脑静注射液脑出血患者人群特征及临床用药特征。采用Apriori算法建立模型,使用Clementine 12.0对全国33家三级甲等医院信息系统数据库的8 369例使用醒脑静注射液的脑出血患者一般信息及用药信息进行分析。结果显示,使用醒脑静注射液的8 369例脑出血患者中,年龄中位数59岁,男-女1.74∶1,职业以体力劳动者最多(31.26%),多于冬季入院(27.46%),节气多在寒露(5.1%),入院病情以一般者居多(50.94%),就诊时首选神经外科(48.82%),住院天数多在15~28 d(29.03%),有42.47%患者住院费用在10 000~50 000元;醒脑静注射液单次给药剂量以10~20 mL最多(46.03%);用药疗程大多在3 d及以下(68.60%);合并1种西药用药频数最高的为利多卡因(5.05%),合并1种中药用药常为化瘀通脉剂(10.73%)。1种中药合并1种西药频次最高的是化瘀通脉剂+地塞米松(8.08%);联合2种西药频数最高的是奥美拉唑+地塞米松(5.07%);联合3种西药频数最高的为奥美拉唑+地塞米松+利多卡因(3.35%);在用药10~20 mL,用药天数>15 d时,治愈和好转的患者最多(44.78%,45.85%)。结果表明,使用醒脑静注射液治疗脑出血患者以中老年居多且男性多于女性,多于冬春时节发病,常与糖皮质激素、质子泵抑制剂、心血管药物等联用预防脑出血并发症,临床用药符合脑出血治疗指南,部分患者存在超疗程使用情况,可为临床医师治疗时提供参考。

Analysis of clinical application characteristics of Xingnaojing Injection in treating cerebral hemorrhage in real world

To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was > 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.