目的 分析2017—2020年天津市肿瘤医院门诊药房蛋白激酶抑制剂的临床应用及用药趋势，为其规范管理和合理应用提供参考。方法 采用WHO推荐的限定日剂量（DDD）法对2017—2020年天津市肿瘤医院门诊药房蛋白激酶抑制剂品种、规格、销售数量、销售金额、用药频度（DDDs）、日均费用（DDC）和排序比（B/A）等进行统计分析。结果 天津市肿瘤医院门诊药房蛋白激酶抑制剂品种从2017年的4种/4个品规增长至2020年的22种/27个品规；销售金额从2017年的716.90万元增长至2020年的17 149.21万元；奥希替尼在所有蛋白激酶抑制剂类药物中增长最为迅速，2020年DDDs值已升至第1位；吉非替尼DDC下降最为明显，且B/A值连续两年≥4.0，其药品价格与利用率最佳；瑞戈非尼与奥希替尼的B/A值最低，仅0.5。结论 随着新医改政策的实施，本院门诊药房蛋白激酶抑制剂类药物药品价格下降较明显，临床可使用品种日趋广泛，符合临床个体化治疗的科学发展方向。

Objective To understand and analyze the clinical application and drug trend of protein kinase inhibitors in the outpatient pharmacy of Tianjin Medical University Cancer Institute and Hospital from 2017 to 2020, and provide references for its standardized management and rational application. Methods The defined daily dose (DDD) method recommended by WHO was used to statistically analyze the types, specifications, sales volume, sales amount, frequency of medication (DDDs), average daily cost (DDC), average daily cost (DDC) and sorting ratio (B/A) of protein kinase inhibitors in outpatient clinics of Tianjin Medical University Cancer Institute and Hospital from 2017 to 2020. Results The types of protein kinase inhibitors in the outpatient pharmacy of Tianjin medical University Cancer Institute and Hospital increased from 4 types/4 specifications in 2017 to 22 types/27 specifications in 2020. The sales amount increased from 7 169 000 yuan in 2017 to 171 492 100 yuan in 2020. Osimertinib has the fastest growth among all protein kinase inhibitor drugs, and the DDDs value has risen to the first place in 2020. The DDC of gefitinib has fallen most significantly, and the B/A value has been two consecutive years ≥ 4.0, its drug price and utilization are the best. Regorafenib and osimertinib have the lowest B/A value, only 0.5. Conclusion With the implementation of the new medical reform policy, the price of protein kinase inhibitor drugs in the outpatient pharmacy of Tianjin Medical University Cancer Institute and Hospital has dropped significantly, and the clinically available varieties have become more extensive, which is in line with the scientific development direction of clinical individualized treatment.

R979.1

国家自然科学基金项目资助（81703454）