121例二线抗结核药品不良反应分析  

121 cases of adverse drug reaction of second-line anti-tuberculosis drugs

作　　者：高利臣[1,2,3] 曹仕鹏 鲁虹[1,2] 李玲[1,2] 李红丽[1,2,3] 罗亚春 GAO Li-chen;CAO Shi-peng;LU Hong;LI Ling;LI Hong-li;LUO Ya-chun(1.Changsha Central Hospital,Changsha 410004,China;Changsha Cancer Institute,Changsha 410004,China;School of Life Science,Hunan University of Science and Technology,Xiangtan 411201,China;Hunan University of Medicine,Huaihua 418000,China)

机构地区：[1]长沙市中心医院,湖南长沙410004 [2]长沙市肿瘤研究所,湖南长沙410004 [3]湖南科技大学生命科学学院,湖南湘潭411201 [4]湖南医药学院,湖南怀化418000

出　　处：《中国感染控制杂志》2018年第12期1070-1074,共5页Chinese Journal of Infection Control

基　　金：湖南省科技重点研发计划项目(2016SK2066);湖南省卫生计生科研计划课题(B2016214);湖南省高层次卫生人才"225"工程药学学科骨干人才培养计划(2017)

摘　　要：目的探讨二线抗结核药品药品不良反应(ADR)发生的特点。方法从某院2017年度ADR报告汇总表中选取二线抗结核药品所致ADR患者的病历,对不同性别、年龄的患者ADR发生情况,ADR类型以及患者各种ADR所涉及的器官系统及其主要临床表现、转归数据信息进行统计分析。结果报告的121例二线抗结核药品ADR患者中,男性占比较高(72例,59. 50%),年龄> 60岁者居多(70例,57. 85%)。引发ADR的药品剂型主要是注射剂型(80例,66. 12%),主要药品是莫西沙星(38例,31. 40%)和左氧氟沙星(29例,23. 96%)。ADR累及的器官系统以全身性为主(69/128,53. 91%),其次是中枢及外周神经系统(22/128,17. 19%)。严重的ADR患者9例(7. 44%),痊愈和好转的ADR患者118例(97. 52%)。结论使用二线抗结核药品ADR多发生于老年患者,尤其以喹诺酮类药品的全身性损害和中枢及外周神经系统损害为主。在诊治过程中,应及时对高危人群和主要治疗药品进行ADR监测和主动干预,并作出应对处理。Objective To explore the characteristics of adverse drug reaction(ADR)of second-line anti-tuberculosis(TB)drugs.Methods Case history of patients with ADR due to use of second-line anti-TB drugs was selected from the ADR report summary table of a hospital in 2017,the occurrence of ADR,types of ADR,patients’organ systems involved in ADR and the main clinical manifestations as well as prognostic data were analyzed.Results Of 121 patients with ADR due to second-line anti-TB drugs,59.50%(n=72)were males,57.85%(n=70)were aged more than 60 years.The main dosage which inducing ADR is injection type(n=80,66.12%),the main drugs were moxifloxacin(n=38,31.40%)and levofloxacin(n=29,23.96%).The main organ system involved in ADR was systemic(69/128,53.91%),followed by central and peripheral nervous system(22/128,17.19%).9 patients(7.44%)were with severe ADR,118 patients(97.52%)were recovered and improved.Conclusion ADR due to use of second-line anti-TB drugs often occurs in elderly patients,the main damage are systemic and peripheral nervous system damage due to use of quinolones.In the course of diagnosis and treatment,the high-risk population and the main therapeutic drugs should be monitored and performed active intervention,and the corresponding measures should be taken.

关 键 词：二线抗结核药品 药品不良反应 用药安全性 合理用药 

分 类 号：R969.3[医药卫生—药理学]