目的 分析天津市津南醫(yī)院近2018－2020年降糖藥物使用情況，為促進本院降糖藥類藥物在臨床的合理使用提供參考。方法 采用回顧性分析方法，對 2018年1月—2020年12月本院降糖類藥物的銷售金額、使用頻度（DDDs）、日均費用（DDC）等進行統(tǒng)計并排序、分析。結果 本院2018年1月－2020年12月胰島素類銷售金額及構成比呈先下降后上升趨勢，口服降糖類藥物銷售金額及構成比呈先上升后下降趨勢，2020年胰島素類的構成比達到了69.86%。口服劑型的降糖藥α-葡萄糖苷酶抑制劑的銷售金額及構成比連續(xù)3年高居榜首。阿卡波糖片的銷售金額始終居首位，瑞格列奈片2 mg的銷售金額排名始終居前3位。除了格列美脲片、鹽酸吡格列酮膠囊、鹽酸吡格列酮片和2019—2020年的的依帕司他片DDC高于10元，其他均低于10元，患者基本無經濟負擔。胰島素各種類的金額排序無明顯浮動，其速效、預混和長效胰島素類似物的銷售金額始終居前3位。除了2018年的短效動物胰島素和長效胰島素類似物的DDC值大于10元，各類胰島素的DDC值均小于10元。胰島素各品種的DDC值無明顯浮動，且均小于30元。胰島素類的B/A比值均接近1.00，說明同步性良好。結論 本院降糖類藥物使用基本合理，個別藥物如阿卡波糖片的使用量明顯超過指南中推薦的一線用藥二甲雙胍類。

Objective To analyze the use of hypoglycemic drugs in Tianjin Jinnan Hospital in recent three years, to provide references for promoting the rational use of hypoglycemic drugs. Methods Using retrospective analysis method, the sales amount, frequency of use (DDDs) and average daily expenses (DDC) of hypoglycemic drugs used in Tianjin Jinnan Hospital from January 2018 to December 2020 were counted and ranked, analysis. Results From January 2018 to December 2020, the sales amount and composition ratio of insulins in Tianjin Jinnan Hospital declined first and then increased. The sales amount and composition ratio of oral hypoglycemic drugs rose first and then declined. The composition ratio of insulin in 2020 reached 69.86%. The sales amount and composition ratio of oral-dose hypoglycemic drugs α-glucosidase inhibitors topped the list for three consecutive years. The sales amount of acarbose tablets always ranks first, and the sales amount of repaglinide tablets 2 mg always ranks in the top three. Except for glimepiride tablets, pioglitazone hydrochloride capsules, pioglitazone hydrochloride tablets and epalrestat tablets from 2019 to 2020, the DDC is higher than 10 yuan, and the others are less than 10 yuan, and patients basically have no financial burden. There is no obvious fluctuation in the amount of various types of insulin, and the sales amount of its quick-acting, pre-mixed and long-acting insulin analogs always ranks in the top three. Except for the DDC values of short-acting animal insulin and long-acting insulin analogues in 2018 that were greater than 10 yuan, the DDC values of all types of insulin were less than 10 yuan. The DDC valuesof various types of insulin did not fluctuate significantly, and they were all less than 30 yuan. The B/A ratio of insulin is close to 1.00, indicating good synchronization. Conclusion The use of hypoglycemic drugs in Tianjin Jinnan Hospital is basically reasonable. The use of individual drugs, such as acarbose tablets, significantly exceeds the first-line metformin recommended in the guidelines.

R977

國家自然科學基金青年項目（81803524）