1 411例住院患者使用静注人免疫球蛋白的合理性研究

目的：探讨住院患者中静注人免疫球蛋白（IVIG）临床应用概况和合理性。方法：回顾调查某院2013年1月-2015年3月住院患者使用IVIG的情况，对患者年龄、性别、疾病诊断、使用数量、用药疗程等信息进行统计汇总，根据临床诊断，评价用药的合理性以及与说明书、治疗指南适应证的相符性。结果：1 411例使用IVIG病例中男女数量基本均等，以0~9岁儿童居多，主要集中在小儿神经专科（28.42%）、新生儿科（15.73%）等科室，常用于白血病、重症肺炎、病毒感染等疾病，平均用药（1.11±0.63）d，平均日剂量9.88 g。1 411例中超说明书用药占64.92%，指南未推荐用药占21.83%。儿童及青少年群体内超说明书占64.26%，指南未推荐占20.73%。结论：该院IVIG超说明书使用情况普遍。为防止药物滥用误用，临床医生应谨慎使用IVIG，避免非适应证、超适应证用药，促进合理用药。

Rationality of intravenous immunoglobulin in 1 411 inpatients

OBJECTIVE To explore the profile and rationality of intravenous immunoglobulin (IVIG).METHODS The situations of hospitalized patients were reviewed by using IVIG from January 2013 to March 2015,and age,sex,diagnosis of disease,dose,and treatment duration were summarized.According to clinical diagnosis,rationality of drug use and whether IVIG conformed to the drug label and treatment guidelines were evaluated.RESULTS A total of 1 411 patients were enrolled,including 788 men and 623 women.All patients used IVIG in our hospital.Most patients were 0 to 9 years old with leukemia,severe pneumonia or virus infection,mainly admitted in departments of pediatric neurology (28.42%) and neonate (15.73%).The average drug treatment cycle was about 1.11±0.63 days and average daily dose was approximately 9.88 g.About 64.92% patients under the drug off label,21.83% did not use the drug as per the guidelines.Of all patients,children and teenagers accounted for 64.26% and 20.73%,respectively.CONCLUSION Off label use of IVIG is common in this hospital.To guarantee rational use of IVIG,clinicians should pay attentions to indicated drug use and avoid drug abuse.