基于药品不良反应监测的糖尿病临床用药优化策略  

Optimized strategies of diabetes clinical medication based on the surveillance of adverse drug reactions

作　　者：赵霞[1,2] 李明[3] 孙庆荣[4] 廖俊[4] 林盛[1] 

机构地区：[1]天津大学管理与经济学部,天津300072 [2]江苏省无锡市药品不良反应监测中心,江苏无锡214028 [3]江苏省药品不良反应监测中心,江苏南京210002 [4]中国药科大学,江苏南京211198

出　　处：《中国农村卫生事业管理》2017年第5期534-537,共4页Chinese Rural Health Service Administration

基　　金：国家自然科学基金资助项目(81373482;81373378)

摘　　要：目的:通过对江苏省糖尿病不良反应/事件(ADR/ADE)监测报告进行分析,加深对糖尿病用药不良反应的认识,促进医院临床对糖尿病患者的合理用药,不断提高医疗质量。方法:从江苏省药品不良反应监测中心数据库中筛选出2010-2015年关于糖尿病用药不良反应/事件(ADR/ADE)监测报告,采用回顾性描述统计和卡方检验等方法全面分析其发生情况及特征。结果:5 387份糖尿病用药ADR/ADE报告中,男性略高于女性;40~69年龄段内患者为4 096例,占76%。其中在0~29岁,≥70岁年龄段内严重不良反应占比率较高;给药途径以口服所占比例最大,为3 325例,占57.27%;所有的给药途径中皮下注射严重不良反应占比率最大,为13.6%;糖尿病ADR/ADE累及的系统-器官主要是胃肠系统损害,达2 527例,占33.81%,其次是代谢和营养障碍,达1 222例,占16.34%。结论:医院应加强糖尿病药物使用管理,在临床用药过程中应谨慎对待不同年龄人群,选择合适的剂型和给药途径,最终减少甚至避免不良反应/事件的发生。Objective To analyze the diabetes adverse reaction/event（ADR/ADE）in Jiangsu province, deepen the understanding of diabetes drug adverse reaction and promote reasonable clinical use of diabetes drugs, so as to improve the quality of medical treatment. Methods Based on ADR monitoring center database of Jiangsu province, we filtrated the di- abetes ADR/ADE reports from 2010--2015 ADR/ADE reports, and made a comprehensive analysis of the occurrence and characteristics of diabetes ADR/ADE by retrospective descriptive statistics and chi-- square test. Results Of 5387 diabetes ADR/ADE reports, the case number of male was slightly more than female; 4096 patients were in the age group between 40 and 69,accounting for 76 % of the total; 70 there were higher rates of serious adverse drug events. in both the age groups between 0 and 29 and not less than Oral administration was adopted in 3325 cases,accounting for 57.27% of the total; the ratio of serious adverse reaction caused by subcutaneous injection was the highest, ac- counting for 13.6 % ;diabetes ADR/ADE--organ involvement of the system was mainly gastrointestinal system damage, which occurred in 2527 cases,accounting for 33.81%, followed by metabolism and nutrition disorder, which occurred in 1222 cases, accounting for 16. 34%. Conclusions The use and management of diabetes drugs should be strengthened in hospitals. In the process of clinical drug use different age groups should be treated with careful choice of appropriate dosage forms and administration route to reduce or even avoid the occurrence of ADR/ADE.

关 键 词：糖尿病 药品不良反应 监测 合理用药 

分 类 号：R587.1[医药卫生—内分泌]