阿奇霉素注射剂致心血管不良反应临床特征与危险因素的单中心真实世界研究  

A single-center,real-world study of the clinical characteristics and risk factors for cardiovascular adverse reactions associated with azithromycin injections

作　　者：杨春华 张媛媛 王立丹 王伟美 平泽 YANG Chun-hua;ZHANG Yuan-yuan;WANG Li-dan;WANG Wei-mei;PING Ze(Department of Pharmacy,Hengshui People's Hospital,Hebei Hengshui 053000,China)

机构地区：[1]衡水市人民医院药学部,河北衡水053000

出　　处：《临床药物治疗杂志》2023年第11期65-70,共6页Clinical Medication Journal

摘　　要：目的探讨阿奇霉素注射剂致心血管不良反应在真实世界中的发生率、临床特点及相关危险因素。方法收集2020年1月至2023年1月衡水市人民医院使用阿奇霉素注射剂的病例,以发生心血管不良反应的患者为病例组,描述性分析心血管不良反应发生率、临床特征及转归,按1∶2比例在未发生心血管不良反应的队列中随机抽取病例为对照组,采用单因素及多因素logistic回归分析心血管不良反应发生的危险因素。结果共纳入12138例患者,其中75例为阿奇霉素注射剂致心血管不良反应,发生率为0.62%。主要临床表现为Q-T间期延长(42.67%)和心律失常(25.33%),以中度(53.33%)和轻度(44.00%)不良反应为主,经停药及对症治疗后预后较好,无死亡病例。单因素及多因素logistic回归分析显示,患者年龄>75岁(OR=1.834,95%CI:1.215~2.768,P=0.025)、阿奇霉素用药时间≥9 d(OR=1.499,95%CI:1.039~2.163,P=0.032)和联用茶碱类药物(OR=2.515,95%CI:1.277~4.953,P=0.041)是阿奇霉素注射剂致心血管不良反应发生的独立危险因素(P<0.05)。结论阿奇霉素注射剂致心血管不良反应属“偶见”不良反应,预后较好,但高龄、用药时间较长和联用茶碱药物的患者应警惕发生心血管不良反应。Objective To explore the incidence,clinical characteristics,and related risk factors of cardiovascular adverse reactions caused by azithromycin injections in the real-world.Methods Patients who received azithromycin injection in Hengshui People's Hospital from January 2020 to January 2023 were collected.Patients with cardiovascular adverse reactions were selected as the case group.Descriptive statistics were used to analyze the incidence,clinical features,and outcome of cardiovascular adverse reactions.Patients were selected in no cardiovascular adverse reactions matched with the ratio of 1∶2 as the control group.Univariate and multivariate logistic regression were used to analyze the risk factors of cardiovascular adverse reactions.Results A total of 12138 patients were included,the incidence of cardiovascular adverse reactions caused by azithromycin injection was 0.62%.The clinical manifestations were prolonged Q-T interval(42.67%)and arrhythmia(25.33%),and the severity was mainly moderate(53.33%)and mild(44.00%).After drug withdrawal and symptomatic treatment,the prognosis was good and no death was reported.Univariate and multivariate logistic regression showed that age over 75 years old(OR=1.834,95%CI:1.215 to 2.768,P=0.025),treatment duration of azithromycin no less than 9 days(OR=1.499,95%CI:1.039 to 2.163,P=0.032)and combined theophylline drugs(OR=2.515,95%CI:1.277 to 4.953,P=0.041)were independent risks factor for cardiovascular adverse reactions caused by azithromycin injection.Conclusion The incidence of cardiovascular adverse reactions caused by azithromycin injection is an"occasional"adverse reaction,and the prognosis is good.However,elderly patients,with long treatment courses of azithromycin injection and theophylline injection should be alert to the occurrence of cardiovascular adverse reactions.

关 键 词：阿奇霉素 心血管不良反应 真实世界数据 影响因素 

分 类 号：R978.5[医药卫生—药品]