杨晓娟 王磊 恽艳琴 文爱东

    摘 要 目的：为临床合理使用曲美他嗪提供参考。方法：对我院2017年1-6月住院患者曲美他嗪的使用情况进行回顾性分析，并评价其使用的合理性。结果：使用曲美他嗪的患者共有3 934例，集中于60～80岁年龄段，男性多于女性，主要疾病类型为冠心病，集中于心血管内科、心血管外科、老年科等科室；其中，合理病例1 252例(占31.83%)，不合理病例2 682例(占68.17%)。不合理用药主要表现为超适应证用药(1 163例，占43.36%)、禁忌证用药(119例，占4.44%)、给药时机不适宜(1 180例，占44.00%)、用法用量不适宜(适应证合理且无禁忌证，220例，占8.20%)。结论：我院住院患者曲美他嗪用药仍存在较为明显的不合理现象。临床医师应严格把握其禁忌证和适应证，医院应通过多种途径及时向临床医师传递最新用药信息，进行合理用药教育，此外还可通过信息化手段限制曲美他嗪的适应证及用法用量，采取多种措施保障患者的用药安全。

    关键词 曲美他嗪；合理性评价；超适应证；禁忌证；给药时机；合理用药；用法用量

    中图分类号 R541；R969 文献标志码 A 文章编号 1001-0408(2018)16-2273-05

    ABSTRACT OBJECTIVE： To provide reference for rational use of trimetazidine in clinic. METHODS： Clinical application of trimetazidine in our hospital during Jan.-Jun. 2017 was analyzed retrospectively to evaluate the rationality of trimetazidine use. RESULTS： Totally 3 934 patients received trimetazidine and mainly aged 60-80 year old； the male was more than female； main type of disease was coronary heart disease； main departments were cardiovascular medicine department， cardiovascular surgery department and geriatric department. There were 1 252 rational cases (accounting for 31.82%) and 2 682 irrational cases (accounting for 68.18%). Main manifestations of irrational drug use included hyper-indication medication (1 163 cases ......