目的 分析2017—2020年天津市腫瘤醫(yī)院門診藥房蛋白激酶抑制劑的臨床應(yīng)用及用藥趨勢(shì)，為其規(guī)范管理和合理應(yīng)用提供參考。方法 采用WHO推薦的限定日劑量（DDD）法對(duì)2017—2020年天津市腫瘤醫(yī)院門診藥房蛋白激酶抑制劑品種、規(guī)格、銷售數(shù)量、銷售金額、用藥頻度（DDDs）、日均費(fèi)用（DDC）和排序比（B/A）等進(jìn)行統(tǒng)計(jì)分析。結(jié)果 天津市腫瘤醫(yī)院門診藥房蛋白激酶抑制劑品種從2017年的4種/4個(gè)品規(guī)增長(zhǎng)至2020年的22種/27個(gè)品規(guī)；銷售金額從2017年的716.90萬(wàn)元增長(zhǎng)至2020年的17 149.21萬(wàn)元；奧希替尼在所有蛋白激酶抑制劑類藥物中增長(zhǎng)最為迅速，2020年DDDs值已升至第1位；吉非替尼DDC下降最為明顯，且B/A值連續(xù)兩年≥4.0，其藥品價(jià)格與利用率最佳；瑞戈非尼與奧希替尼的B/A值最低，僅0.5。結(jié)論 隨著新醫(yī)改政策的實(shí)施，本院門診藥房蛋白激酶抑制劑類藥物藥品價(jià)格下降較明顯，臨床可使用品種日趨廣泛，符合臨床個(gè)體化治療的科學(xué)發(fā)展方向。

Objective To understand and analyze the clinical application and drug trend of protein kinase inhibitors in the outpatient pharmacy of Tianjin Medical University Cancer Institute and Hospital from 2017 to 2020, and provide references for its standardized management and rational application. Methods The defined daily dose (DDD) method recommended by WHO was used to statistically analyze the types, specifications, sales volume, sales amount, frequency of medication (DDDs), average daily cost (DDC), average daily cost (DDC) and sorting ratio (B/A) of protein kinase inhibitors in outpatient clinics of Tianjin Medical University Cancer Institute and Hospital from 2017 to 2020. Results The types of protein kinase inhibitors in the outpatient pharmacy of Tianjin medical University Cancer Institute and Hospital increased from 4 types/4 specifications in 2017 to 22 types/27 specifications in 2020. The sales amount increased from 7 169 000 yuan in 2017 to 171 492 100 yuan in 2020. Osimertinib has the fastest growth among all protein kinase inhibitor drugs, and the DDDs value has risen to the first place in 2020. The DDC of gefitinib has fallen most significantly, and the B/A value has been two consecutive years ≥ 4.0, its drug price and utilization are the best. Regorafenib and osimertinib have the lowest B/A value, only 0.5. Conclusion With the implementation of the new medical reform policy, the price of protein kinase inhibitor drugs in the outpatient pharmacy of Tianjin Medical University Cancer Institute and Hospital has dropped significantly, and the clinically available varieties have become more extensive, which is in line with the scientific development direction of clinical individualized treatment.

R979.1

國(guó)家自然科學(xué)基金項(xiàng)目資助（81703454）