187例一线抗结核药品临床ADR特征分析  

Adverse drug reactions in 187 cases of first-line anti-tuberculousis drugs

作　　者：高利臣[1,3] 曹仕鹏[2] 文丹丹 李红丽[1,3] GAO Li-chen;CAO Shi-peng;WEN Dan-dan;LI Hong-li(Department of Pharmacy,Cancer Institute,Phase I Clinical Trial Centre,Changsha Central Hospital,Changsha 410004;Chest Center,Changsha Central Hospital,Changsha 410004;School of Life Sciences,Hunan University of Science and Technology,Xiangtan Hunan 411201)

机构地区：[1]长沙市中心医院药学部,长沙市肿瘤研究所,长沙市中心医院Ⅰ期临床研究中心,长沙410004 [2]长抄市中心医院肺科医院,长沙410004 [3]湖南科技大学生命科学学院,湖南湘潭411201

出　　处：《中南药学》2019年第9期1577-1580,共4页Central South Pharmacy

基　　金：湖南省科技重点研发计划项目(No.2016SK2066);湖南省中医药科研计划项目(No.201940);长沙市科技计划项目(No.kq1801144);长沙市中心医院科研重点项目(No.YNKY201901)

摘　　要：目的探讨一线抗结核药品不良反应(ADR)发生特点,为其临床合理使用提供用药指导。方法从某院2017年度ADR报告汇总表中选取一线抗结核药品所致ADR患者病例,对患者性别、年龄、ADR发生情况、ADR类型、ADR累及器官/系统及其主要临床表现、转归数据信息进行统计分析。结果 187例ADR报告,以男性为主(115例,61.50%),ADR发生随年龄增长而呈现递增趋势,年龄> 60岁患者居多(70例,37.43%);引发ADR的剂型主要是口服制剂(142例,75.94%);主要药品是异烟肼(42例,22.46%)、利福平(27例,14.44%)、吡嗪酰胺(23例,12.30%)、乙胺丁醇(21例,11.23%);累及器官/系统以皮肤损害为主(113/328,34.45%),其次是消化系统(80/328,24.39%);严重ADR 54例(28.88%);痊愈和好转176例(94.12%),多数患者ADR具有较好转归。结论一线抗结核药品ADR多发生于老年患者,尤以皮肤和消化系统损害为主,94.12%患者具有较好转归。医药护人员应根据ADR发生的性别、年龄、器官损害及药物特征进行主动监测和干预,促进一线抗结核药品临床合理使用。Objective To determine the features of adverse reactions of first-line anti-tuberculosis drugs, and provide references for clinical rational drug use. Methods Totally 187 adverse reactions of the first-line antituberculosis drugs in hospitalized tuberculosis patients from January to December in 2017 were retrospectively analyzed. Results The 187 ADRs of first-line anti-tuberculosis drug included 115 reported in male patients(61.50%) and 70 cases over 60 years old(37.43%). The majority of ADRs(75.94%) were caused by oral administration. The drugs causing ADRs mainly included isoniazid in 42 cases(22.46%), rifampicin in 27(14.44%), pyrazine in 23(12.30%), and ethambutol in 21(11.23%). The ADRs covered skin damage(34.45%), followed by digestive system damage(24.39%). Severe ADRs occurred in 54 cases(28.88%), recovery and improvement of ADRs in 176 cases, and most of the ADRs showed better outcome finally(94.12%). Conclusion ADRs due to first-line anti-tuberculosis are often observed in elderly patients. We should monitor and intervene the high-risk groups timely, and fully understand the ADR features of first-line anti-tuberculosis drugs, improve the safety and rational use of these drugs.

关 键 词：一线抗结核药品 不良反应 临床特征 临床合理用药 

分 类 号：R968[医药卫生—药理学] R969[医药卫生—药学]