重庆市2015年至2020年药源性过敏性休克报告分析  

Analysis of reports of allergic shock in Chongqing between 2015 and 2020

作　　者：陈诚 邓莉 刘松青 杜倩 奚鑫 CHEN Cheng;DENG Li;LIU Songqing;DU Qian;XI Xin(Department of Pharmacy,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China;Chongqing Adverse Drug Reaction Monitoring Center,Chongqing 401120,China)

机构地区：[1]重庆医科大学附属第三医院药剂科,重庆401120 [2]重庆市药品不良反应监测中心,重庆401120

出　　处：《中国药物警戒》2023年第4期460-464,共5页Chinese Journal of Pharmacovigilance

基　　金：2020年重庆市科卫联合医学科研项目(2020MSXM055)。

摘　　要：目的研究药源性过敏性休克的发生规律及临床特点,为临床防范严重药物过敏反应提供参考。方法采用回顾性分析方法,对重庆市药品不良反应监测中心2015年1月1日至2020年12月31日过敏性休克不良反应报告的患者基本信息、过敏性休克发生时间、涉及药物、涉及给药途径、转归及死亡病例等进行统计分析。结果药源性过敏性休克在60岁及以上老年人群中发生率更高;超过75%的病例发生在给药30 min内;静脉用药发生率最高(85.56%);引发过敏性休克前5位的药品类别依次为抗感染药物(48.80%)、中药注射剂(9.62%)、神经系统药物(8.37%)、消化系统药物(5.49%)及维生素类、电解质、酸碱平衡和营养药物(4.43%)。引发过敏性休克前5位的药品为头孢曲松钠、左氧氟沙星、青霉素钠、哌拉西林钠他唑巴坦钠及头孢哌酮钠舒巴坦钠,均为抗菌药物。结论多种药物均可能引发过敏性休克,且往往发生迅速。临床应进一步加强对静脉用药的监测与管理,特别是中老年人群;加强抗感染药物、中药注射剂等的合理使用;密切观察用药反应,及时识别过敏性休克的发生并做好抢救准备,以降低过敏性休克导致严重后果的发生率。Objective To study the patterns and characteristics of drug-induced allergic shock,and to provide reference for clinical prevention of severe drug allergic reactions.Methods A retrospective analysis method was used to process the reports of allergic shock collected by Chongqing Adverse Reaction Monitoring Center between 2015 and 2020.The basic information about patients,the time allergic shock occurred,drugs involved,routes of administration,outcomes and cases of death was statistically analyzed.Results The incidence of drug-induced allergic shock was higher in the elderly(≥60 years old).More than 75%of the cases experienced allergic shock within 30 min of administration.The proportion of allergic shock caused by intravenous drugs was the highest(85.56%).The top five categories of drugs that caused anaphylactic shock were anti-infective drugs(48.80%),traditional Chinese medicine injections(9.62%),nervous system drugs(8.37%),digestive system drugs(5.49%),vitamins,electrolytes,acid-base balance and nutritional drugs(4.43%).The top five drugs causing allergic shock were ceftriaxone,levofloxacin,penicillin,piperacillin/tazobactam and cefoperazone/sulbactam,all of which were antibacterial drugs.Conclusion A range of drugs can cause allergic shock that often occurs quickly.Clinical monitoring and management of intravenous medications should be improved,especially among the elderly.Antibiotics and traditional Chinese medicine injections should be used more rationally while adverse drug reactions have to be observed closely in order to detect allergic shock in time and take immediate measures to reduce the incidence of severe consequences of allergic shock.

关 键 词：过敏性休克 药源性疾病 严重过敏反应 药品不良反应 静脉用药 抗感染药 头孢曲松钠 

分 类 号：R994.11[医药卫生—毒理学]