台灣地區血脂異常用藥之流行病學研究

中文摘要研究背景：在歐美許多工業化國家中，冠狀動脈心臟病（coronary artery disease，CAD）是最常見且致死率最高的疾病。台灣地區過去數十年來由於農業人口減少，白領階級增加，社會經濟發展以及醫療科技進步，使得民眾的體能消耗降低，飲食生活型態改變，以及人口逐漸老化，因而罹患冠心病的機會也有逐年增加的趨勢，冠心病發生的原因眾多，在眾多因素當中以血脂異常與冠心病的關係最為明確。研究目的：本研究之目的在於探討台灣地區血脂異常的用藥比率與用藥之趨勢。研究方法：本研究主要利用全民健康保險學術研究資料庫之門診處方及治療明細檔，從中選取處方藥品中有開立治療血脂異常藥物之病患就醫人次資料，就病患特性，包括性別、年齡與醫事機構所在地區別對用藥比率與用藥趨勢等研究變項資料，進行統計分析。研究結果：本研究分析1997~2001年，共2,584,147張處方與2,316,858位病患。在用藥比率方面，台灣地區五年血脂異常藥物用藥比率為千分之七，有逐年明顯增加的趨勢；男性明顯高於女性；隨年齡層增加而增加，且不同年齡層之間的用藥比率有顯著的差異；都市化程度越高的地區用藥比率越高，且城鄉地區之間有顯著的差異性。藥物使用量與耗用金額亦呈現逐年明顯增加的情形；治療血脂異常的藥物主要是以 statin 類與 fibric acid derivatives 為主，且 statin 類呈現逐年明顯增加而 fibric acid derivatives呈現逐年明顯減少之趨勢。病患主要合併疾病為代謝症候群與腦血管疾病。結論：台灣地區血脂異常的用藥比率與用藥趨勢呈現明顯增加的情形，男性高於女性，老年人高於年輕人，都市高於鄉村；藥物使用量與耗用金額趨勢漸漸以statin類為主；主要的合併疾病為與冠心病有密切相關的疾病，如代謝症候群與腦血管疾病，顯示血脂異常與冠心病有密切的關聯性。關鍵字：冠心病、血脂異常用藥、趨勢

關鍵字

趨勢；血脂異常用藥；冠心病

並列摘要

ABSTRACT Background: Coronary Artery Disease is among the leading cause of death in various industrialized nations of the world, such as the United States and many countries in Europe. During the past decades, there has been a decline in the agricultural work force and an increase in the number of white collar workers in Taiwan. Due to advances in medical care and social changes the age structure of Taiwan's population has changed so that a greater proportion of the population is now in the older age groups. This, coupled with changes in eating habits had led to an increase in the incidence of CAD. Of the many etiologic factors of CAD, dyslipidemia is the one most closely associated with it. Objective: To investigate the rate and trend of various prescription drugs used in the treatment of dyslipidemia in Taiwan. Methods: This study uses the Out Patient Prescription and Medical files from the National Healthcare Insurance database. Patients who have received prescription medication for the treatment of dyslipidemia were selected and the association of their use with age, sex, medical institution and geographical area was assessed. Results: We studied a total of 2,584,147 prescriptions among 2,316,858 patients from the years 1997 to 2001. The rate of using dyslipidemic medications is 7/1000 and has been significantly increasing steadily in the past 5 years. We observe that males were over represented among medication users and that increasing age was significantly correlated with increasing use. The usage rate was significantly higher for those residing in urban areas relative to people from rural areas. Spending for dyslipidemic medications has been significantly increasing steadily in recent years. These medications are mostly statins or fibric acid derivatives. There is a significant increase in the use of statins and a decrease in the use of fibric Acid derivatives. Comorbid diseases include metabolic disorders and cerebrovascular diseases. Conclusion: The rate of dyslipidemic drugs use is significantly increasing steadily in Taiwan. Users are more likely to be male, elderly, and be from urban areas compared to non-users. The medications are statins mostly. The major comorbid diseases associated with dyslipidemia are Coronary Artery Diseases, including cerebrovascular diseases and metabolic disorders. Key words: Coronary Artery Disease, dyslipidemic medications, trend, statins