某院心内科住院患者严重和禁忌的潜在药物相互作用横断面研究  

Cross-sectional Study of Major and Contraindicated Potential Drug-Drug Interactions in Hospitalized Cardiac Patients in Our Hospital

作　　者：幸晓琼 王红梅[1] 杨佳丹[1] 邱峰[1] XING Xiao-qiong;WANG Hong-mei;YANG Jia-dan;QIU Feng(The First Affiliated Hospital of Chongqing Medical Initer-sity,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院,重庆400016

出　　处：《中国药学杂志》2021年第8期694-698,共5页Chinese Pharmaceutical Journal

基　　金：重庆市技术创新与应用发展专项资助(cstc2019jscx-msxmX0190);重庆市科卫联合医学项目资助(2020MSXM120)。

摘　　要：目的分析心内科住院患者严重和禁忌潜在药物相互作用(potential drug-drug interactions,pDDIs),并对其相关危险因素进行评估。方法收集我院2018~2020年期间3~5月年龄大于18岁且至少服用1种以上药物的心内科住院患者用药医嘱,筛查并分析可能发生的严重和禁忌药物相互作用。结果共纳入893例患者,其中77.5%(692/893)的患者至少存在一个严重或禁忌pDDI。氯吡格雷/雷贝拉唑(16.2%),螺内酯/氯化钾(11.6%)和替格瑞洛/阿司匹林(4.9%)是最常见的严重和禁忌pDDIs组合。影响严重和禁忌pDDIs发生的单因素有10个,多因素Logistic回归分析发现多药联用(≥5种),高Charlson合并症指数得分(≥1分)和使用中药注射剂是严重和禁忌pDDIs发生的危险因素。结论心血管病患者住院期间严重和禁忌pDDIs发生率高,对存在上述危险因素的患者,应警惕用药伤害的发生。OBJECTIVE To analyze major and contraindicated potential drug-drug interactions(pDDIs)among hospitalized cardiac patients and assess the related risk factors associated with these interactions.METHODS The medical advice of cardiovascular inpatients over 18 years old and taking at least one more drugs in our hospital from March to May in 2018-2020 was collected.Drug Assistant of Dingxiangyuan were used to screen and analyze the possible major and contraindicated DDIs.RESULTS A total of 893 patients were enrolled in this study,and 77.5%(692/893)patients had at least one major or contraindicated pDDI.Clopidogrel/rabeprazole(16.2%),spironolactone/potassium chloride(11.6%),and ticagrelor/aspirin(4.9%)were the most common interacting pairs.In univariate analysis,there were 10 factors associated with major and contraindicated pDDIs.Multivariate logistic analysis showed that polypharmacy(≥5 types),high Charlson Comorbidity Index score(≥1)and use of traditional Chinese medicine injection were the risk factors associated with major and contraindicated pDDIs.CONCLUSION The prevalence of major and contraindicated pDDIs in hospitalized cardiac patients is high,and patients with above identified risk factors should be alert to the occurrence of medication harm.

关 键 词：心血管病 住院患者 潜在药物相互作用 影响因素 

分 类 号：R969.3[医药卫生—药理学]