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目的 了解上海市郊区成人慢性阻塞性肺疾病(COPD)患者的用药模式。方法 基于上海郊区自然人群队列和生物样本库(SSACB)，回顾性选取2023年1月1日至12月31日期间952例COPD患者作为研究对象。根据面对面问卷调查获得人口学资料、生活方式等相关数据；根据队列区域健康信息共享平台获得就诊与用药信息。使用Microsoft Excel 2021建立数据库，统计分析在SPSS 20.0中完成。结果 研究对象就诊总频数为1 433人次，门诊、急诊和住院比例分别为63.7%、16.8%和19.5%。研究对象中使用单一药物的比例为19.9%，使用药物数量≥4种的比例为39.0%，且绝大多数(占比88.0%)使用至少一种合并症治疗药物。COPD药物使用前4位依次为吸入型糖皮质激素(占比55.3%)、祛痰药(占比54.0%)、长效β2受体激动剂(占比50.3%)和全身型糖皮质激素(占比43.6%)。男性对短效β2受体激动剂、长效抗胆碱能药物、甲基黄嘌呤、全身型糖皮质激素和祛痰药5类药物的使用比例高于女性(P<0.05)；女性在糖尿病、高血脂、骨质疏松、贫血以及抑郁/焦虑5种合并症治疗药物的使用比例高于男性(P<0.05)。有序回归分析结果显示，男性(OR=1.59,95%CI:1.17～2.16)与合并症治疗药物种数增加(OR=1.32,95%CI:1.18～1.49)这2种因素显著增加COPD用药种数(P<0.05)。结论 研究对象用药模式复杂，且存在性别和合并症差异，建议在COPD管理中充分考虑这些因素，制订个体化治疗策略，提升精准管理水平，改善患者预后。
Abstract：AIM To understand medication patterns among adults with chronic obstructive pulmonary disease(COPD) in suburban Shanghai. METHODS Based on the Shanghai Suburban Adult Cohort and Biobank(SSACB), 952 COPD patients in 2023 were selected as study subjects. Demographic information, lifestyle and other related data were obtained based on face-to-face questionnaires; consultation and medication information were obtained based on the cohort regional health information sharing platform. Microsoft Excel 2021 was used to establish the database, and the statistical analysis was done in SPSS 20.0. RESULTS The total hospital visiting number of the study population was 1 433 and the proportions of outpatient, emergency and inpatient were 63.7%, 16.8% and 19.5% respectively. Among the study population, 19.9% used only one COPD medication, while 39.0% required more than 4 medications. Notably, 88.0% of patients were concurrently using at least one comorbidity medication. The top 4 COPD medications used(in order of prevalence) were, inhaled corticosteroids(ICS)(55.3%), expectorants(54.0%), long-acting β2 agonists(LABA)(50.3%), and systemic corticosteroids(SCS)(43.6%). The proportions of men using medications for the 5 categories, such as short-acting β2 agonists(SABA), long-acting muscarinic antagonist(LAMA), methylxanthines, SCS and expectorants were higher(P < 0.05). The proportions of women using medications for the 5 comorbidities of diabetes, hyperlipidemia, osteoporosis, anemia, and depression/anxiety were higher than these of men(P < 0.05). The ordinal regression analysis revealed that male patients(OR=1.59, 95%CI: 1.17-2.16) and higher comorbidity medication counts(OR=1.32, 95%CI: 1.18-1.49) independently predicted increased number of COPD medications(P < 0.05). CONCLUSION The medication patterns of the study subjects are complex, and there are gender and comorbidity differences. It is recommended that these factors be fully considered in the management of COPD in order to facilitate the development of individualized therapeutic strategies, enhance precision management, and improve patient prognosis.
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基本信息:
DOI：10.19577/j.1007-4406.2025.10.002
中图分类号:R563.9;R969.3
引用信息:
[1]白海凡,王娜,赵根明,等.上海市郊区成人慢性阻塞性肺疾病患者用药模式研究[J].中国临床药学杂志,2025,34(10):726-733.DOI:10.19577/j.1007-4406.2025.10.002.
基金信息:
复旦闵行康联体项目（编号2023FM06）