2008-2013年北京医疗机构中低分子量肝素不良反应分析  

Analysis of adverse drug reactions induced by low molecular weight heparin in Beijing medical institutions from 2008 to 2013

作　　者：王华光[1] 王颖[1] 刘丽宏[1] 

机构地区：[1]首都医科大学附属北京朝阳医院药事部,北京100020

出　　处：《药学服务与研究》2015年第5期366-369,共4页Pharmaceutical Care and Research

摘　　要：目的：探讨低分子量肝素（10wmolecularweightheparin，LMWH）药品不良反应（ADRs）的发生规律与特点，为临床安全、合理用药提供参考。方法：汇总2008年7月至2013年8月的5年间北京医疗机构上报的76例LMWH的ADRs，对病人年龄和性别分布、用药原因、药品使用方法、ADRs累及的器官系统表现及合并用药等情况进行统计分析。结果：男性ADRs发生的构成比明显高于女性（69．74％VS30．26％），61～80岁病人是ADRs发生构成比最高的人群（占30．26％）。皮下注射是最常见的给药途径（占84．21％），肌内注射和部分静脉滴注为不适宜的给药途径。ADRs发生构成比居前三位的临床表现分别为肝功能损害（占53．95％），皮肤黏膜及器官出血性损害（占14．47％）和局部反应（占10．53％）。合并使用降脂药和其他抗凝药物（如华法林、阿司匹林、氯吡格雷）会促进肝功能损害和出血性损害的发生。结论：临床工作者应熟悉LMWH的常见ADRs、危险因素及正确使用方法，促进临床安全、合理用药。Objective： To explore the regular pattern and features of adverse drug reactions （ADRs） of low molecular weight heparin （LMWH） and to provide reference for safe and rational medication clinically. Methods：Totally, there were 76 cases of ADRs induced by LMWH, that were reported by Beijing medical institutions from 2008 to 2013. Analyses were made on the distribution of the patient age and gender, reasons for medication, methods of drug administration, the organic clinical manifestations of ADRs and combined medications. Results： The constitution ratio of ADRs in the male was significantly higher than that of the female （69.74~ vs 30.26%）. The patients with an age range of 61 to 80 years were the highest ADR-suscepti- ble population, accounting for 30.26~//oo. Subcutaneous injection was the most common route of administration, accounting for 84.21%. Intramuscular injection and certain intravenous infusion were inappropriate routes of administration. The top three clinical manifestations of ADRs were in sequence： impaired liver function, accounting for 53.95%; mucocutaneous and organ hemorrhagic lesion, accounting for 14.47% ; and local reactions, accounting for 10.53 %. Combined use of lipid-lowering drugs and other anticoagulants （such as warfarin, aspirin, clopidogrel） would have higher risks of liver damage and hemorrhagic lesion. Conclusion： Clinical physicians should be familiar with common ADRs of LMWH, risk factors and its proper applica- tion, so as to promote safe and rational drug application clinically.

关 键 词：低分子量肝素 药物副反应报告系统 医院 

分 类 号：R944.11[医药卫生—药剂学] R973.2[医药卫生—药学]