左氧氟沙星相关性肝损害及血细胞减少的自动监测研究  

Automatic Surveillance of Levofloxacin-related Hepatic Impairment and Hypocytosis Cases

作　　者：贾王平[1] 郭代红[1] 朱曼[1] 寇炜[1] 王啸宇[1] 胡鹏洲 赵博宇[1] 

机构地区：[1]解放军总医院药品保障中心

出　　处：《药物流行病学杂志》2017年第1期37-39,45,共4页Chinese Journal of Pharmacoepidemiology

基　　金：2014年全军后勤科研重点项目(编号:BWS14R039)

摘　　要：目的:利用"医疗机构ADE主动监测与智能评估警示系统"分析左氧氟沙星致肝损害和血细胞减少的发生规律。方法:借助系统回顾性调取我院2015年10月~2016年9月使用左氧氟沙星的住院患者病历,设置"肝功能""血小板""血红蛋白""白细胞"四个模块的事件配置器参数,分析系统阳性报警率及各ADR发生率,并对左氧氟沙星致肝损害的相关因素进行分析。结果:借助系统自动监测2 675例次左氧氟沙星用药患者,每个模块平均用时约11 min;经临床药师再评价,肝损害、血小板减少、贫血、白细胞减少、中性粒细胞减少的ADR发生率分别为1.92%,0.75%,1.34%,1.82%,1.59%。左氧氟沙星致肝损害在年龄、性别、用药天数上差异无统计学意义,但在体重指数(BMI)上差异有统计学意义。结论:专项软件系统可以高效快速进行左氧氟沙星相关性肝损害和血细胞减少等ADR的自动监测,且能够初步预测其ADR风险因素,有助于降低临床用药风险。Objective： To analyze the regularity of hepatic impairment and hypocytosis caused by levofloxacin with inpatient＇s active surveillance and assessment system of adverse drug events. Methods： The data of hospitalized patients in our hospital from October in 2015 to September in 2016 were extracted and analyzed retrospectively. Event configuration parameters for＂liver function＂,＂blood platelet＂,＂hemoglobin＂,＂white blood cell＂were set,and positive warning rate,incidence rate of adverse drug reactions were analyzed. Related factors of hepatic impairment caused by levofloxacin were analyzed. Results： A total of 2 675 cases using levofloxacin were automatically surveilled,and the runtime of this system was about 11 minutes every model. After manual re-evaluation by clinical pharmacists,the incidence rate of hepatic impairment,thrombopenia,anemia,leukopenia,and neutropenia was respectively 1. 92%,0. 75%,1. 34%,1. 82% and 1. 59%.There was no significant differences in age、sex and medication days associated with hepatic impairment caused by levofloxacin between in this study,but BMI were significantly associated with hepatic impairment risk. Conclusion： The automatic surveillance of hepatic impairment and hypocytosis caused by levofloxacin could be realized by this system with high speed and efficiency. It also could be used for predicting the risk factors of adverse drug reaction of levofloxacin,which could help to reduce the risk of clinical medication.

关 键 词：左氧氟沙星 肝损害 血细胞减少 药品不良反应 自动监测 

分 类 号：R978.1[医药卫生—药品]