目的：了解我国质子泵抑制剂( PPI)与氯吡格雷联合应用处方现状。方法数据来自《医院处方分析合作项目》2010-2013年全国六城市88家医院门诊和住院数据，每家医院每年随机抽取40 d门诊处方和住院医嘱，包括患者基本信息、用药情况、诊断和用药金额等项目，从中提取PPI与氯吡格雷联合使用的数据，用Foxpro 8．0数据库软件进行统计分析。结果使用氯吡格雷的患者中，氯吡格雷联合PPI所占比例：门诊患者为2．1%~3．6%，住院患者为16．1%~31．6%；奥美拉唑、埃索美拉唑联合氯吡格雷的比例，由2010年的第1位和第2位，下降到2013年的第3位或第4位，而泮托拉唑、雷贝拉唑与氯吡格雷联合的比例逐渐上升到第1位或第2位；心内科、老干科、普通内科及神经内科4个科室，奥美拉唑、埃索美拉唑联合氯吡格雷的比例较高。结论临床医生已随着相关治疗指南的更迭调整用药行为，关注到PPI与氯吡格雷药物相互作用会引发的心脏病风险，对重点科室应加强宣传教育，为患者优先选择相互作用影响小的药物，以保证治疗效果及兼顾规避用药风险。%Objective To investigate the prescription situation of clopidogrel combined with proton pump in-hibitor(PPI). Methods The data was from Hospital Prescription Analysis of Cooperative Project which included out-patient prescriptions and inpatient medical orders from 88 hospitals of six cities in China. 40-day-prescriptions were ran-domly selected each year from 2010 to 2013,the preseriptions included patients′ basic information,medication,diagno-sis and drug costs,etc. The data of clopidogrel-proton pump inhibitors combination were extracted. The Foxpro 8. 0 da-tabase software was used. Results In the patients used clopidogrel,patients used clopidogrel-PPI counted for 2. 1% ~3. 6% in outpatient,and 16. 1% ~31. 6% in inpatient; the ranking of proportion of omeprazole+clopidogrel,esome-prazole+clopidogreldecreased from first and second (2010) to third and fourth (2013),and the proportion of panto-prazole+clopidogrel,rabeprazole+clopidogrel ranked first and second (2013). The proportion of omeprazole and es-omeprazole combined with clopidogrel was high in department of cardiology,department of elderly cadre outpatient,in-ternal medicine and department neurology. Conclusion Clinicians has been adjusting their medication behavior accord-ing to new guidelines. They has paid close attention to PPI and clopidogrel interaction which may cause risk of heart diseases. The key departments should strengthen publicity and education: less drugs interaction should be preferred choice to ensure therapeutic effects and avoid risks.
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