住院患者甘草酸制剂相关低钾血症主动监测系统的建立  

Establishment of an active monitoring system for glycyrrhizic acid preparation related hypokalemia in hospitalized patients

作　　者：张帆[1] 王彦[1] 陈菲[1] 贾光伟[1] 

机构地区：[1]山东省聊城市人民医院药剂科,252000

出　　处：《药物不良反应杂志》2016年第5期347-351,共5页Adverse Drug Reactions Journal

摘　　要：目的：建立住院患者甘草酸制剂相关低钾血症主动监测系统。方法以医院信息系统（HIs）为基础，结合Client/server（C/s）架构、Oracle 10g数据库、C语言、ODBC技术和DDL触发器构建住院患者甘草酸制剂相关低钾血症主动监测系统，根据预调查结果将血钾〈3.5 mmol/L、使用补钾药物和突然停药作为甘草酸制剂相关低钾血症的触发器。将触发器程序嵌入HIs后，由2名主管药师检索本院2014年6月1日至2015年5月31日全部出院患者的电子病历，筛选使用甘草酸制剂患者的电子病历进行触发器检测，评价触发器阳性患者甘草酸制剂与低钾血症的因果关系，计算ADR检出率，并与同期甘草酸制剂相关低钾血症实际上报情况进行比较。结果主动监测系统共检测病例1405例，男性778例（55.4％），女性627例（44.6％）；年龄1~94岁，≤20岁者86例（6.2％），21~40岁者419例（29.8％），41~60岁者492例（35.0％），≥61者408例（29.0％）；患者所在科室居前3位者为乳腺及甲状腺外科（319例，22.7％）、消化内科（192例，13.7％）和感染性疾病科（172例，12.2％）；原发疾病居前3位者为肿瘤（425例，30.2％）、慢性肝病（263例，18.7％）和肝功能异常（239例，17.0％）；使用的甘草酸制剂数量居前3位者为异甘草酸镁注射液（742例，52.8％）、注射用复方甘草酸苷（501例，35.6％）和复方甘草酸苷注射液（101例，7.2％）。共637例检测结果为触发器阳性，其中1、2、3项触发器阳性者分别为259例（40.7％）、290例（45.5％）、88例（13.8％）。因果关系评价结果显示，低钾血症与甘草酸制剂关系为肯定、很可能、可能者分别为2、120和78例，触发器阳性者ADR检出率为31.4％（200/637）。同期通过国家药品不良反应监测系统上报的甘草酸制剂相关低钾血症为2例，前者是后者的100倍。结论成功建立了住院患�Objective To establish an active monitoring system of glycyrrhizic acid preparation related hypokalemia in hospitalized patients. Methods The active monitoring system of glycyrrhizic acid preparation related hypokalemia in hospitalized patients was built based on the hospital information system （HIs）,combined with Client/server（ C/s）architecture,10g Oracle database,C language,ODBC technology and DDL trigger. According to the pre-investigation＇s results,blood potassium 〈3. 5 mmol/L （A）,using potassium supplement drugs（B）and sudden withdrawal（C）were as glycyrrhizic acid preparation related hypokalemia triggers. The trigger program was embedded into the HIs. The electronical medical record,s of all discharged patients from June 1,2014 to May 31,2015 were retrieved by two pharmacists-in-charge. The electronical medical records of the patients who used glycyrrhizic acid preparation were selected for trigger detection. The causality between glycyrrhizic acid preparation and kaliopenia in patients who were trigger detection positive were evaluated. The relevance ratio of ADR was counted, and compared with the actual reporting situation of glycyrrhizic acid preparation related hypokalemia at the same period. Results A total of 1405 cases were detected by the active monitoring system The cases comprised of 778 males and 627 females with age 1 to 94 years. The cases with age≤20, 21-40,41-60 and ≥61 were 86（6. 2%）,419（29. 8%）,492（35. 0%）,and 408（29. 0%）, respectively. The top three departments maximum number of cases were breast and thyroid surgery（ 319 cases,22. 7%）,department of gastroenterology（ 192 cases,13. 7%）,and department of infectious diseases（172 cases,12. 2%）. The top three primary diseases were tumor（425 cases,30. 2%）,chronic liver disease（263 cases,18. 7%）,and abnormal liver function（239 cases,17. 0%）. The top three amount of glycyrrhizic acid preparation were magnesium isoglycyrrhizinate injection （ 742 cases, 52. 8%）, compound glycyrrhi

关 键 词：药物检测 甘草酸 低钾血症 药物相关副作用和不良反应 

分 类 号：R969.3[医药卫生—药理学]