129例奥氮平药品不良反应及血药浓度监测临床分析  

Analysis of 129 Cases of Adverse Reactions and Clinical Application of Plasma Concentration Monitoring of Olanzapine

作　　者：曾环思[1] 钟彩妮[2] 钟易霖 彭陈陈 张璇[1] ZENG Huansi;ZHONG Caini;ZHONG Yilin;PENG Chenchen;ZHANG Xuan(Institute of Pharmacy,Shenzhen Kangning Hospital,Shenzhen Guangdong 518020,China;Department of Pharmacy,Shenzhen Kangning Hospital,Shenzhen Guangdong 518020,China)

机构地区：[1]深圳市康宁医院研究所,广东深圳518020 [2]深圳市康宁医院药学部,广东深圳518020

出　　处：《中国药物警戒》2020年第11期818-822,共5页Chinese Journal of Pharmacovigilance

基　　金：广东省高水平临床重点专科(深圳市配套建设经费)资助(SZGSP013);深圳市卫生计生系统科研项目(SZFZ2018039)深圳市科技计划项目(JCYJ20150402093137766)。

摘　　要：目的分析奥氮平药品不良反应及血药浓度监测的临床应用,为临床合理用药提供参考。方法分析2017年1月至2019年6月深圳市康宁医院上报129例奥氮平药品不良反应(ADR)报告,探讨患者性别、年龄、剂量、合并用药及血药浓度及浓度/剂量比值(C/D)与奥氮平ADR的关系。结果129例奥氮平ADR主要为神经精神系统损害、肝胆系统损害及心血管系统损害,以肝功能异常、锥体外系反应和静坐不能最为常见;患者年龄以19~40岁居多,女性患者ADR报告多于男性,男性发生严重ADR占比高于女性(P<0.05);联合用药发生严重ADR比率与单一用药无显著性差异(P>0.05);72.87%患者在ADR发生期间监测了血药浓度,严重ADR血药浓度及C/D值与一般不良反应无显著性差异(P>0.05)。结论临床应用奥氮平时应加强其ADR监测和治疗药物监测,减少合并用药,保障临床用药安全。Objective To analyze the adverse drug reactions(ADR)and plasma concentration monitoring of olanzapine so as to provide reference for clinical rational use of drugs.Methods A retrospective analysis of 129 cases of ADR by Shenzhen Kangning Hospital from January 2017 to June 2019 induced by olanzapine was conducted to explore the relationships between the patients’gender,age,dosage,drug combination,plasma concentration and concentration-dosage ratio(C/D)and ADR of olanzapine.Results ADR mainly damaged the neuropsychiatric system,hepatobiliary system and cardiovascular system.The most common clinical manifestations were abnormal liver function,extrapyramidal diseases and akathisia.Most of the patients were aged 19 to 40.ADR reports involved more females than males,but in reports of serious ADR,males outnumbered females(P<0.05).There was no significant difference in the incidence of serious ADR between combined medication and single medication(P>0.05).72.87%of the patients had their plasma concentrations monitored during the occurrence of ADR.There was no significant difference in the plasma concentration or C/D value between ADR and serious ADR(P>0.05).Conclusion When olanzapine is used in clinic,clinicians should strengthen the monitoring of ADR and therapeutic drugs,reduce drug combination,and ensure the safety of clinical drug use.

关 键 词：奥氮平 药品不良反应 血药浓度 合并用药 

分 类 号：R994.11[医药卫生—毒理学]