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目的了解核苷(酸)类似物抗病毒治疗的慢性乙型肝炎患者合并用药情况现状。方法对2015年5~8月北京佑安医院门诊接诊的应用核苷(酸)类药物抗病毒治疗的部分慢性乙型肝炎患者进行问卷调查,调查内容包括抗病毒药物、伴随疾病、目前合并用药等。查阅检索药物适应证、禁忌证、用法用量、不良反应及药物-药物间相互作用等。结果对1 782例患者进行问卷调查,抗病毒单一药物治疗1 338例。合并服用其他药物1 052例(59.0%),其中1种药物562例(53.4%),2种290例(27.6%),3种117例(11.1%),4种53例(5.0%),5种17例(1.6%),6种及以上13例(1.2%)。有1种伴随疾病需合并用药者212例,2种149例,3种以上24例。合并用药种类达91种(肝病辅助用药27种,29.7%),其中39种(42.9%)不在相关疾病指南或专家共识所推荐的治疗药物中。合并使用的药物中有潜在肝脏不良反应的34种(37.4%),存在药物相互反应的亦有34种(37.4%)。结论抗病毒治疗的慢性乙型肝炎患者合并用药十分普遍,对肝脏的潜在毒性反应及药物-药物相互作用未能得到充分重视。
Objective To understand the status of combined medication of patients with chronic hepatitis B treated with nucleoside (acid) analog anti-virus. Methods A questionnaire survey was conducted on some patients with chronic hepatitis B who were treated with nucleoside (acid) anti-virus drugs at the Beijing You’an Hospital from May to August 2015. The survey included antiviral drugs, concomitant diseases, current merger Medication and so on. Access to search for drug indications, contraindications, usage and dosage, adverse reactions and drug-drug interactions. Results A total of 1 782 patients were surveyed and 1 338 antiviral monotherapy was performed. A total of 1 052 patients (59.0%) took other drugs in combination with 562 (53.4%) of the 1 drug, 290 (27.6%) of the 2 patients, 117 (11.1%) of the 3 patients and 53 (5.0%) of the 4 patients Five of the 17 patients (1.6%), 6 and more 13 cases (1.2%). There are one kind of concomitant diseases need to be combined with 212 cases, two kinds of 149 cases, more than three kinds of 24 cases. There were 91 kinds of combined medication (27 kinds of liver disease auxiliary medication, 29.7%), of which 39 kinds (42.9%) were not in the treatment of the drugs recommended by relevant disease guidelines or expert consensus. There were 34 (37.4%) of the potential adverse drug reactions in the combined drugs and 34 (37.4%) in the drug-drug interactions. Conclusions Antiviral therapy is very common in patients with chronic hepatitis B. The potential toxicity to the liver and the drug-drug interaction have not been given sufficient attention.