目的 了解2014—2018年北京、上海、广州、成都、天津、郑州、杭州七城市口服抗凝药在房颤疾病中的应用情况。方法 通过医院处方合作分析项目，筛选出七城市共80家医院诊断房颤的处方数据作为研究对象。对房颤患者就诊人数、各药物年度处方张数、金额、用药频度（DDDs）、限定日费用（DDC）、排序比（B/A）等进行统计，并比较口服抗凝药物的使用现状和趋势。结果 2014—2018年，七城市房颤患者就诊人数逐年增加，以2018年增加人数为著，较2017年房颤患者人数增加约127%。华法林的处方数量、处方金额、DDDs呈增长态势，但增长缓慢，处方数量构成比在逐年降低，由97%降至32%；处方金额构成比由36%降至2%；DDDs构成比由98%降至46%，增长率由17%降至5%。利伐沙班和达比加群酯的处方数量、处方金额、DDDs都呈现较快的增长趋势。结论 无论是处方数量、处方金额、DDDs等新型口服抗凝药的使用比例均逐渐超过了传统抗凝药华法林，房颤患者中临床医生使用新型抗凝药的倾向性日益增高。但华法林作为一传统经典经济的抗凝药物，新型口服抗凝药并不能完全取代。

Objective To realize the application status of oral anticoagulant drugs used in atrial fibrillation disease (AF) in 80 hospitals in 7 cities including Beijing, Shanghai, Guangzhou, Chengdu, Tianjin, Zhengzhou, and Hangzhou from 2014 to 2018. Methods The information of outpatient prescriptions and inpatient medical records which used oral anticoagulants were screened out through the hospital prescription ananlysis project. The prescriptions with AF related-diagnosis were alslo selected. The prescriptions of oral anticoagulant drugs used in AF was statistically analyzed by the number of visits for AF, prescription amount, drug amount, defined daily doses (DDDs), defined daily cost (DDC), and drug sequence ratio (B/A). Results From 2014 to 2018, the number of patients with AF in 7 cities increased year by year, and the number of patients with AF increased by about 127% in 2018. The number of prescriptions, amount of prescriptions and DDDs of warfarin increased, but the growth was slow. The proportion above mentioned decreased year by year, from 97% to 32%, from 36% to 2%, and from 98% to 46%. The prescription quantity and prescription amount and DDDs of rivaroxaban and dabigatran showed a rapid growth trend. Conclusion The proportion of new oral anticoagulants such as prescription quantity, prescription amount, and DDDs gradually exceeded that of the traditional anticoagulant warfarin, and the tendency of clinicians to use new anticoagulants in patients with AF increased day by day. However, warfarin, as a classical anticoagulant, cannot be completely replaced by the new oral anticoagulant.

R972