| 摘要: | 急性心肌梗塞(Acute myocardial infraction；AMI)為具有高致死率之疾病，為了解AMI病人發病時藥物治療與其發病後整體用藥的狀況，本研究探討AMI病人其用藥歷程，藉此了解病人用藥與不同年齡、性別與共病症之關聯性。本研究為採用全民健康保險資料庫之次級資料庫研究，研究對象為2000年住院診斷為AMI之病人(ICD-9-CM code: 410)，追蹤病人從2000年到2013年或死亡之所有門診與住院的用藥紀錄。本研究以Anatomical Therapeutic Chemical code分類AMI病人之用藥類型，並以描述性統計分析AMI病人住院後所有的用藥在不同年紀、性別與共病(高血壓、糖尿病、高血脂與慢性腎臟疾病)中用藥歷程之差異。研究結果指出N02BA01 (Aspirin)為AMI病人最主要用藥。在住院用藥部分，C01CA04 (Dopamine)為指標性用藥，AMI病人年齡越大，使用C01CA04 (Dopamine)的比例越高(<55歲：36.8%，55~64歲：50.8%，65~74歲：55.2%，≧75歲：62.3%；P=0.037)；而女性病人住院使用C01CA04 (Dopamine)的比例亦顯著高於男性 (女性：男性= 67.7%：50.2%，P= 0.004)。在門診用藥部分，慢性腎臟病病人使用B01AC04 (Clopidogrel)的比例顯著低於沒有慢性腎臟病的病人 (9.1% vs. 29.2%；P=0.042)。本研究結果表明，在不同年齡層、性別或共病症的情況下，AMI病人有著不同的藥品使用比例與用藥歷程，此資訊可提供臨床醫師、照護者或病人了解其用藥狀況並進一步發展用藥策略。
Patients with acute myocardial infarction (AMI) have high mortality. In this study, we are concerned the life course of medications among AMI patients using the Longitudinal Health Insurance Database 2000. The association between medications and different patients’ characteristics, including age, gender, and comorbidities was also investigated. The study subjects included all patients who were admitted to hospitals with the primary diagnosis of AMI (ICD-9-CM code: 410) in 2000, and the records of medication among those patients was tracked until the end of the database collection (2013) or death. The descriptive statistical analysis was used to summarize data within the classification of Anatomical Therapeutic Chemical code. According to the records of hospitalization, our results presented that N02BA01(Aspirin) was majorly used in AMI patients. In addition, elderly patients (<55 years: 36.8%, 55~64 years: 50.8%, 65~74 years: 55.2%, >=75: 62.3%; P=0.037) and females (female: male = 67.7% : 50.2%, P=0.004) had higher proportion of using C01CA04 (Dopamine) in hospitalization. For the records of medication in outpatients, AMI patients with chronic kidney disease used B01AC04 (Clopidogrel) was less than those without (9.1% vs. 29.2%; P=0.042). Our findings demonstrated that AMI patients with the older age, females, hypertension, diabetes, and chronic kidney disease could have different life course of medications. It is important to provide physicians, caregivers, or patients with this information to develop the strategy of medications in AMI patients. |
