胰高糖素样肽-1受体激动剂临床应用合理性和安全性分析  

Clinical application rationality and safety analysis of glucagon like peptide-1 receptor agonist

作　　者：罗银龙 曾彩芳[1] 罗柳金[1] LUO Yinlong;ZENG Caifang;LUO Liujin(Department of Pharmacy,the Second Affiliated Hospital of Guangzhou Medical University,Guangdong,Guangzhou 510000,China)

机构地区：[1]广州医科大学附属第二医院药学部,广东广州510000

出　　处：《中国医药科学》2024年第12期51-54,共4页China Medicine And Pharmacy

基　　金：广东省广州市卫生健康科技一般引导项目(20231A010055)。

摘　　要：目的调查住院患者接受胰高糖素样肽-1受体激动剂(GLP-1RA)治疗的情况,了解该类药物的应用现状和不良反应并分析其危险因素,为规范其临床合理应用提供依据。方法汇总国内外GLP-1RA权威指南、临床研究和专家共识,结合说明书形成GLP-1RA临床应用合理性评价标准。回顾性收集2021年1月至2023年4月广州医科大学附属第二医院使用GLP-1RA的住院患者的病历资料,按照已制订的评价标准进行合理性和安全性分析,并提出合理用药建议。结果共有261例患者应用GLP-1RA,其中有效病例258例,不合理使用病例共160例,不合理使用率达62.02%,以超适应证用药不合理和用法用量不适宜为主要原因;发生不良反应共3例,发生率为1.16%,主要是低血糖和转氨酶升高;临床使用期间应多关注患者血糖和肝肾功能指标,关注GLP-1RA的适应证、用法用量、禁忌证和联合用药等方面。结论GLP-1RA降糖、减重及保护心血管的作用备受关注,本研究针对医生使用GLP-1RA临床实践存在的问题和不良反应,提供具体可行的指导建议,以促进GLP-1RA的合理使用。Objective To investigate the status of inpatients undergoing treatment with glucagon like peptide-1 receptor agonist(GLP-1RA),understand the current application status and adverse reactions of this type of drugs,and analyze its risk factors,so as to provide basis for standardizing its clinical rational application.Methods The authoritative guidelines,clinical research and expert consensus of GLP-1RA at home and abroad were summarized,and the rationality evaluation criteria of GLP-1RA clinical application with the instructions was formed.The medical records of inpatients using GLP-1RA in the Second Affiliated Hospital of Guangzhou Medical University from January 2021 to April 2023 were retrospectively collected,and the rationality and safety were analyzed according to the established evaluation criteria,and suggestions for rational medication were put forward.Results A total of 261 patients were treated with GLP-1RA,including 258 effective cases and 160 cases of irrational medication,with a rate of 62.02%.The main reasons were irrational medication beyond indications and inappropriate usage and dosage.There were 3 cases of adverse reactions,with an incidence rate of 1.16%,mainly including hypoglycemia and elevated transaminases.During clinical medication,more attention to patients’blood glucose and liver and kidney function indices,and the indications,usage and dosage,contraindications and combined medication of GLP-1RA should be paid.Conclusion The hypoglycemic,weight loss and cardiovascular protective effects of GLP-1RA have attracted much attention.The problems and ADRs in doctors’clinical practice of using GLP-1RA are aimed in this study,and concrete and feasible guidance and suggestions are provided to promote the rational use of GLP-1RA.

关 键 词：胰高糖素样肽-1受体激动剂 评价标准 不良反应 2型糖尿病 减重 

分 类 号：R969.3[医药卫生—药理学]