目的 建立阿加曲班藥物利用評(píng)價(jià)標(biāo)準(zhǔn)（DUE），評(píng)價(jià)阿加曲班的臨床應(yīng)用情況。方法 以阿加曲班藥品說(shuō)明書為基礎(chǔ)，參考相關(guān)指南和專家共識(shí)，并通過(guò)與臨床專家討論，建立阿加曲班DUE標(biāo)準(zhǔn)。采用回顧性調(diào)查方法，對(duì)天津市第四中心醫(yī)院2021年1月—12月使用阿加曲班的住院患者病例進(jìn)行合理性評(píng)價(jià)，評(píng)價(jià)項(xiàng)目包括適應(yīng)證、禁忌證、用法用量、溶媒選擇、療程、聯(lián)合用藥、橋接轉(zhuǎn)換和不良反應(yīng)監(jiān)測(cè)等。結(jié)果 共納入322份病例，其中完全符合評(píng)價(jià)標(biāo)準(zhǔn)的病例為209份（64.91%）。評(píng)價(jià)項(xiàng)目符合率較低的項(xiàng)目主要為適應(yīng)證（87.58%）和用法用量（83.85%），用法用量不合理主要是特殊人群用藥劑量未調(diào)整、特殊病理狀態(tài)患者用藥劑量未調(diào)整、給藥頻次不合理。結(jié)論 建立的阿加曲班DUE標(biāo)準(zhǔn)具有較強(qiáng)的科學(xué)性和實(shí)用性，天津市第四中心醫(yī)院阿加曲班臨床應(yīng)用中尚存在一些問(wèn)題，應(yīng)進(jìn)一步加強(qiáng)干預(yù)，以優(yōu)化阿加曲班的臨床應(yīng)用。

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.

R971

天津市衛(wèi)生健康科技項(xiàng)目(ZC20109)