2021年天津市第四中心医院阿加曲班药物利用评价标准的建立与应用

目的 建立阿加曲班药物利用评价标准（DUE），评价阿加曲班的临床应用情况。方法 以阿加曲班药品说明书为基础，参考相关指南和专家共识，并通过与临床专家讨论，建立阿加曲班DUE标准。采用回顾性调查方法，对天津市第四中心医院2021年1月—12月使用阿加曲班的住院患者病例进行合理性评价，评价项目包括适应证、禁忌证、用法用量、溶媒选择、疗程、联合用药、桥接转换和不良反应监测等。结果 共纳入322份病例，其中完全符合评价标准的病例为209份（64.91%）。评价项目符合率较低的项目主要为适应证（87.58%）和用法用量（83.85%），用法用量不合理主要是特殊人群用药剂量未调整、特殊病理状态患者用药剂量未调整、给药频次不合理。结论 建立的阿加曲班DUE标准具有较强的科学性和实用性，天津市第四中心医院阿加曲班临床应用中尚存在一些问题，应进一步加强干预，以优化阿加曲班的临床应用。

Establishment and application of drug use evaluation standard of argatroban in Tianjin Fourth Central Hospital in 2021

Objective To establish the drug use evaluation (DUE) standard of argatroban and evaluate clinical use of argatroban.Methods Based on the drug instructions of argatroban,related relevant guidelines and expert consensuses,combined with clinical expert consultation results,the evaluation criteria for argatroban was established.A retrospective study was conducted to evaluate the rationality of medical records of inpatients received argatroban in Tianjin Fourth Central Hospital from January to December 2021.The evaluation items included indications,contraindications,usage and dosage,solvent selection,course of treatment,combined medication,bridge conversion,adverse reaction monitoring and so on.Results A total of 322 medical records were included,209(64.91%) of which fully met the evaluation criteria.The evaluation items with lower coincidence rate were mainly indication (87.58%) and usage and dosage (83.85%).The irrational usage and dosage were mainly due to the unadjusted dose for special population,unadjusted dose for patients with special pathological state,and unreasonable administration frequency.Conclusion DUE established for argatroban is scientific and practical.There are still some problems in the clinical application of argatroban in Tianjin Fourth Central Hospital,and further intervention should be strengthened to optimize clinical application of argatroban.