抗结核药物不良反应376例分析  

Retrospective Analysis of 376 Cases of Adverse Reactions to Antituberculosis Drug

作　　者：李娜 陈洁 罗季 陈永刚 彭江丽 喻明丽 李生浩 LI Na;CHEN Jie;LUO Ji;CHEN Yong-gang;PENG Jiang-li;YU Ming-li;LI Sheng-hao(Dept.of Pharmacy,The Third People’s Hospital of Kunming,Kunming Yunnan 650041,China;Dept.of Liver Disease,The Third People’s Hospital of Kunming,Kunming Yunnan 650041,China)

机构地区：[1]昆明市第三人民医院药剂科,云南昆明650041 [2]昆明市第三人民医院肝病科,云南昆明650041

出　　处：《昆明医科大学学报》2021年第4期117-121,共5页Journal of Kunming Medical University

基　　金：云南省科技厅地方本科高校联合专项基金资助项目(2018FH001-087);昆明市科技保障民生发展计划重点基金资助项目(2019-1-S-25318000000808);昆明市卫健委卫生科研课题基金资助项目(2020-03-08-113)

摘　　要：目的探讨结核患者经抗痨治疗后出现药物不良反应(adverse reaction,ADR)的具体类型、出现时间、年龄构成,为临床合理、安全、有效用药提供一定的参考。方法收集昆明市第三人民医院于2015年1月至2019年12月收治的376例因服用抗结核药物而出现不良反应的患者的病历资料,并采用SPSS软件进行数据分析。结果患者经抗痨治疗后出现ADR的时间多集中在前10 d,且男性出现ADR的几率高于女性,但差异无统计学意义(P>0.05)。结核患者在服用利福平(rifampicin,RFP)与异烟肼(isoniazid,INH)后出现肝毒性的几率较高(P<0.05),结核患者服用吡嗪酰胺(pyrazinamide,PZA)后出现高尿酸血症的几率较高(P<0.05)。患者服用乙胺丁醇(ethambutol,EMB)后出现皮肤瘙痒的发生率较高(P<0.05)。结论抗结核药物可能导致的ADR多为高尿酸血症、瘙痒、皮疹、肝损伤等。患者初次用药后10d内可能因药物的刺激产生相应的ADR。因此,临床医生在其工作中需重点关注高风险人群以降低患者用药后出现ADR的风险。Objective To explore the specific types,occurrence time and age structure of adverse reaction(ADR)in tuberculosis patients after anti-tuberculosis treatment,so as to provide certain reference for rational,safe and effective drug use in clinical practice.Methods The data of 376 patients with adverse reactions due to antituberculosis drugs admitted to Kunming Third People’s Hospital from January 2015 to December 2019 were collected,and the data were analyzed using SPSS software.Results The occurrence of ADR in patients after antituberculosis treatment was mostly likely to occur in the first 10 days,and the incidence of ADR in males was higher than that in females,but the difference was not statistically significant.The incidence of hepatotoxicity in TB patients after taking rifampicin(RFP)and isoniazid(INH)was higher(P<0.05),and the incidence of hyperuricemia in TB patients after taking pyrazinamide(PZA)was higher(P<0.05).The incidence of pruritus was higher in patients taking ethambutol(EMB)(P<0.05).Conclusion ADRs caused by antituberculosis drugs are mostly hyperuricemia,pruritus,rash,liver damage,etc.Patients may develop ADRs within 10 days of initial dose.Therefore,clinicians should pay special attention to high-risk groups to reduce the occurence of ADR after medication.

关 键 词：肺结核 抗痨治疗 个体化给药 不良反应 

分 类 号：R978.3[医药卫生—药品]