目的 调查分析南京地区2016—2018年47家医院抗血小板与抗凝血药物的临床应用情况与变化趋势，为其临床合理使用提供参考依据。方法 采用用药频度（DDDs）排序法与金额排序法，对南京地区47家医院2016—2018年使用的抗血小板与抗凝血药物的品种、销售金额、构成比、DDDs、限定日费用（DDC）等进行回顾性统计和分析。结果 2016—2018年，南京地区抗血小板与抗凝血药物的年销售金额逐年增长率分别为9.02%与10.06%。氯吡格雷、低分子肝素、依诺肝素、利伐沙班、贝前列素钠、阿加曲班、替格瑞洛7种药物的销售金额连续3年排在前列，且所占总销售金额的比例3年均超过80%。氯吡格雷与华法林等药物的DDDs值连续3年稳居前列，且所占总DDDs的比例连续3年超过50%。氯吡格雷连续3年排序比（B/A）值为1.00，华法林的DDC值最低，比伐卢定的DDC值最高。结论 抗血小板与抗凝血药物在南京地区医院应用广泛，销售金额与使用量整体上呈增长后趋于平稳的趋势，大部分药物的DDC呈降低趋势。

Objective To evaluate the application and tendency of antiplatelet and anticoagulant drugs in 47 hospitals in Nanjing Area from 2016 to 2018. Methods The utilization of antiplatelet and anticoagulant drugs in 47 hospitals in Nanjing Area from 2016 to 2018 were analyzed statistically in respect of varieties, consumption sum, DDDs, etc. Results The annual in-creased rate of the consumption sum of antiplatelet and anticoagulant drugs was 9.02% and 10.06%, respectively. Top 7 drugs in the list were clopidogrel, low molecular weight heparin, enoxaparin, rivaroxaban, beraprost sodium, argatroban, ticagrelor. The total annual consumption sum exceeded 80%. Top 3 drugs in the list of total DDDs always were clopidogrel and warfarin. The total DDDs exceeded 50%. B/A values of clopidogrel is 1 in three years, warfarin has the lowest DDC and bivalirudin has the highest DDC. Conclusion Antiplatelet and anticoagulant drugs are widely used in hospitals in Nanjing Area. The sales and usage are increasing and tending to be stable, and the vast majority of daily drug cost is decreasing.

R973

南京大学医院管理研究所管理项目（NDYG2019006）