欧阳红涛（湖南省脑科医院，湖南长沙410007）



2012-2014年某脑科医院药品不良反应分析及防治对策

欧阳红涛
（湖南省脑科医院，湖南长沙410007）

〔摘要〕目的调查分析医院上报的药品不良反应（ADR）的特点与规律，探讨ADR的防治对策，为患者安全用药提供参考。方法回顾性分析某脑科医院2012-2014年上报的ADR 579例，从患者的性别、年龄、药物品种、给药途径、不良反应累及器官、临床表现情况进行分析。结果579例ADR中男性271例，女性308例。给药途径以静脉给药最多为313例（50.73%），其次为口服254例（41.17%）。静脉给药与非静脉给药比较差异有统计学意义（P＜0.01）。ADR药品种类中以精神障碍类药物最多为165例（28.25%），其次是抗感染药物和中药制剂，分别为87例（14.89%）和77例（13.18%）。三者比较差异有统计学意义（P＜0.01）。系统器官损害以皮肤及其附件最多为189例（32.6%），其次为消化系统113例（19.5%）。结论用药前应充分了解药物及患者的ADR情况，减少联合用药，谨慎使用静脉给药。选择合适的药物及给药方式，注意监测。

〔关键词〕药品不良反应；分析；防治对策

Analysis and Control Measures of Adverse Drug Reactions in One Brain Hospital during 2012-2014

OUYANG Hongtao
（Hunan Brain Hospital, Changsha, Hunan 410007, China）

〔Abstract〕Objective To provide reference for the safety of patients by investigating the characteristics and regularity of adverse drug reactions（ADR）reported by hospital and control measures of ADR. Methods A retrospective analysis of 579 cases of ADR by a Brain Hospital reported in 2012-2014. The patients' gender, age, drug species, route of administration, adverse reactions involving the organ, clinical manifestations were analyzed. Countermeasure of ADR were discussed. Results In 579 cases of ADR, 271 cases were males, 308 cases were females. The route of intravenous administration was the most about 313 cases（50.73%）, followed by oral administration about 254 cases（41.17%）. There are significant differences in the comparison between the intravenous administration and non intravenous administration（P＜0.01）. The most ADR cases was induced by mental disorder drugs about 165 cases（28.25%）, followed by anti infective drugs and Chinese medicine preparations, respectively, 87 cases（14.89%）and 77 cases（13.18%）. There are statistical significance between the three above （P＜0.01）. Skin and accessories damage were the most about 189 cases（14.89%）in all ADR cases, followed by the digestive system damage about 113 cases（19.5%）. Conclusion Before medication should be fully aware of the drug and patients with ADR, reduce the combination of drugs, use intravenous drug delivery route carefully. Select the appropriate drugs and drug delivery methods, pay attention to monitoring during treatment.

〔Keywords〕adverse drug reactions, analysis, control measures

药品不良反应（ADR）是患者在用药过程中出现的与用药目的无关的有害反应。几乎所有的药物都可能引起ADR，只是每个患者发生的几率和程度不同。ADR除了与药物的药理作用、药物/代谢物之间相互作用有关，还与患者的自身因素如种族、性别、年龄、身体状况及个体差异等有关。药物联用易致其代谢、转运发生改变，从而导致ADR。如：瑞舒伐他汀与艾曲波帕合用后，后者因抑制OATP1B1（肝脏特异性摄取转运体）和BCRP（乳腺癌耐药蛋白），抑制了瑞舒伐他汀的摄取和消除，增加了瑞舒伐他汀暴露，易导致ADR[1]。……