摘要
目的分析内分泌病区因药物不良反应(ADR)住院患者的临床资料,为临床安全用药提供参考。方法收集2011年1月至2012年6月在解放军总医院内分泌病区出院患者的病历资料,根据临床表现和ADR关联性评价标准确定因药物不良反应住院的病例,并对ADR类型、致ADR药物、住院时间、住院费用及转归进行回顾性分析。结果共收集到3187例患者的病历,其中15例因药物不良反应住院,占0.47%。男性7例,女性8例,平均年龄(59±16)岁,平均住院时间(13.5±9.7)d,平均住院费用(9182±4258)元。入院时诊断为ADR相关者4例(27.0%),出院时诊断为ADR相关者6例(40.0%),分析病例资料确定为ADR相关者5例(33.0%)。6例既往有药物或食物过敏史。不良反应包括低血糖、低血钾、肾小管性酸中毒、肝酶升高、电解质紊乱以及甲状腺功能减退,与内分泌系统疾病的临床表现相似。15例患者停药及对症治疗后均好转出院。引起ADR的药品包括降糖药、降糖类中成药及保健品、甲巯咪唑和阿德福韦酯等。结论本研究中引起不良反应的药物均为内分泌病区常用药。临床医师在应用上述药物时应严密监测不良反应的体征和症状,并掌握诊断、鉴别诊断及治疗的方法。
Objective To analyze the clinical data of hospitalized patients due to adverse drug reactions （ADR） in endocrine ward in order to provide the basis for safe drug use in clinical practice. Methods The clinical data of discharged patients＇ medical records in Chinese PLA General Hospital endocrine ward from January 2011 to June 2012 were collected. The hospitalized patients due to ADR were diagnosed according to the clinical manifestations and the ADR evaluation criterion. The type of ADR, drugs associated with adverse reactions, duration of hospitalization, cost of hospitalization and outcome of patients were retrospectively analyzed. Results A total of 3187 patients＇medical records were collected. Of them, 15 patients （0.47%） were hospitalized due to ADR. They comprised 7 males and 8 females with an average age of （59 ± 16） years, an average duration of hospitalization of （ 13.5 ± 9.7） days, and an average cost of （9182 ± 4258） yuan. Of them, four patients （27%） were diagnosed with drug-related adverse reactions on admission, six （40%） were diagnosed with drug-related adverse reactions on discharging from hospital, and the other five patients （33%） were diagnosed with drug-related adverse reactions by analyzing the medical records. Six patients had drug or food allergic history. The type of ADR included hypoglycaemia, hypokalemia, renal tubule acidosis, liver enzyme elevations, electrolyte disturbances, and hypothyroidism. The symptoms were similar to those of the endocrine system diseases. Fifteen patients improved and discharged after drug withdrawal and symptomatic treatment. The drugs related to adverse reactions included hypoglycemic drugs, hypoglycemic Chinese patent medicine and health products, methimazole, and adefovir. Conclusion The drugs that cause adverse reactions in this study are commonly used medications in the endocrine ward. The clinicians should closely monitor the signs and symptoms of adverse reactions when using above-mentioned drugs, and should he aware of the methods of diagnosis, differentialdiagnosis, and management.
出处
《药物不良反应杂志》
2012年第5期273-276,共4页
Adverse Drug Reactions Journal
关键词
内分泌疾病
药物不良反应
住院
endocrine diseases
adverse drug reactions
hospitalization
