目的 了解临床抗帕金森病药物治疗费用的变化情况,探讨单胺氧化酶B型抑制剂(MAO-BI)与多巴胺受体激动剂(DAs)临床疗效及治疗费用差异.方法 通过对2014—2019年全国30家医院的门诊帕金森病患者治疗药物处方进行统计分析,归纳及总结抗帕金森病药物的人均药品金额、人均取药量、日均治疗费用等,并对MAO-BI与DAs的常用治疗方案进行成本-效果分析.结果 共纳入帕金森病患者8420例,处方分析结果显示:2014—2019年患者人均取药量及人均药品金额的降幅分别为14.0％,18.2％.司来吉兰处方金额比例及取药量比例增长率分别为268.8％,317.2％,其平均日治疗费用为3.74元.成本-效果分析结果显示:与联合DAs组相比,复方左旋多巴联合MAO-BI组加入第三大类药物平均时长延长60.57 d(P<0.05),平均日治疗费用降低16.20元(P<0.05).结论 2014—2019年间帕金森病患者抗帕金森病药物人均治疗费用不断下降,MAO-BI的处方金额占比与取药量占比不断增加,而平均日治疗费用却在不断减少.在复方左旋多巴的治疗基础上加用MAO-BI比加用多巴胺受体激动剂在延迟联用第三种抗帕金森病药物、减少平均日治疗费用方面具有明显优势.

Objective:To understand the risk factors of the prognosis of children with hand, foot and mouth disease(HFMD), and the threshold of related indexes.Methods:By retrospective analysis, 80 HFMD children admitted to Zhongshan County People's Hospital from September 2018 to November 2019 were selected. According to the prognosis, the children were divided into good prognosis group ( n=55) and poor prognosis group ( n=25). The general data, occurrence of related symptoms, laboratory indicators were compared between the two groups. ROC curve was used to determine the value of biochemical indicators in predicting the prognosis of HFMD children. Differential information was included in the Logistic regression model to identify the risk factors of poor prognosis of HFMD children. Results:The areas under the curve of lactate clearance, cardiac output and PaO 2/FiO 2 were 0.879, 0.767 and 0.675, respectively. Logistic regression analysis showed that lactate clearance rate < 25.655% ( OR=2.689, 95% CI: 1.467-4.929), cardiac output<2.465 L/min( OR=1.487, 95% CI: 1.078-2.051), PaO 2/FiO 2<271.645 mmHg (1 mmHg=0.133kPa) ( OR=3.689, 95% CI: 1.251-10.878), hyperglycemia >8.3 mmol/L ( OR=5.423, 95% CI: 1.389-21.173) and convulsion( OR=11.258, 95% CI: 1.201-105.531) were the risk factors for poor prognosis of HFMD. Conclusions:Early symptoms such as hyperglycemia and convulsion, lactate clearance rate < 25.655%, cardiac output < 2.465 L/min, PaO 2/FiO 2 <271.645 mmHg may cause poor prognosis in children with HFMD, and it requires timely attention of clinicians and intervention.

2008年8月30日-31日,在瑞士巴塞尔举行的全球医院药学大会(Global Conference on theFuture of Hospital Pharmacy)是国际药学联合会FIP第68届年会的会前会,也是全球医院药学的第一次大会.共有98个国家的代表参加.