阿司匹林在儿童应用中的不良反应分析  

Analysis of adverse drug adverse reactions in the clinical application of aspirin in children

作　　者：朱彦 李志玲[1] 孙华君[1] ZHU Yan;LI Zhiling;SUN Huajun(Department of Pharmacy,Shanghai Children's Hospital,Children's Hospital of Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院药剂科,上海200062

出　　处：《世界临床药物》2021年第10期925-930,共6页World Clinical Drug

摘　　要：目的分析目前国内外发表的关于阿司匹林致儿童不良反应的文献,为阿司匹林在儿童川崎病中的使用安全性提供依据。方法计算机检索CNKI、万方医学、PubMed文献数据库,同时补充检索百度学术,中文检索词为“阿司匹林”“儿童”“安全性”“不良反应”,英文检索词为“aspirin”“children”“safety”“adverse reaction”“case report”。对符合纳入标准的文献,提取不良反应发生情况等信息,对提取的信息进行汇总分析。结果最终共纳入26篇文献,其中个案报道25篇,临床观察1篇;不良反应共40例。结果显示,儿童使用阿司匹林后发生的不良反应发生率排在前两位的是阿司匹林哮喘和消化道出血,分别占总例数的25%及22.5%。不良反应发生时间最快为用药后15 min,最长在连续用药27 d后发生。结论儿童患者使用阿司匹林的总体安全性较好,可能发生的不良反应包括胃肠道反应(恶心、呕吐、腹痛、胃肠道出血或溃疡等),荨麻疹、哮喘、血管神经型水肿等过敏反应,皮肤黏膜出血,头晕、头痛、癫痫等神经系统不良反应及耳鸣、短暂失聪、肝酶升高,还有Reye综合征、大疱性表皮松解型药疹和极少数药物超敏反应综合征等严重不良反应的报道。40例不良反应中,1例死亡(Reye综合征),其余经停药及有效治疗后好转。Objective To provide reference for the safety of aspirin in children with Kawasaki disease,the literatures published at home and abroad on the adverse reactions of aspirin in children were analyzed.Methods CNKI,Wangfang medical database,PubMed were searched,and Baidu academic was supplemented.Chinese retrieval words:"aspirin","children","safety"and"adverse reactions".English retrieval words:"aspirin","children","safety","adverse reaction"and"case report".The literatures that met the inclusion criteria were extracted and the information of adverse reactions were summarized and analyzed.Results A total of 26 articles were included.There were 25 case reports and 1 clinical observation research,including 40 cases of adverse reactions.The analysis showed that the top two adverse reactions to aspirin in children were"aspirin asthma"(25%)and gastrointestinal bleeding(22.5%).The earliest time of adverse reactions was after taking aspirin 15 minutes and the longest time was 27 days after continuous administration.Conclusion Aspirin safety is better in children.The possible adverse reactions include gastrointestinal adverse reactions(nausea,vomiting,abdominal pain,gastrointestinal bleeding or ulcers,etc.),urticaria,asthma,vascular nerve edema and allergic adverse reactions,skin and mucosal bleeding,dizziness,headache,epilepsy and other neurological adverse reactions,tinnitus,transient deafness,liver enzyme elevation.In addition,serious adverse reactions such as Reye syndrome,large epidermolysis bullous eruption and a very small number of drug hypersensitivity syndrome had been reported.Among 40 cases of adverse reactions,1 child died(Reye syndrome),the rest cases improved after withdrawal and effective treatment.

关 键 词：阿司匹林 不良反应 儿童 川崎病 

分 类 号：R985[医药卫生—药品]