特殊人群肺结核患者抗结核治疗期间不良反应分析

Adverse reactions associated with anti-tuberculosis treatment in special populations: an analysis

目的探讨老年人、儿童、营养不良及合并其他慢性疾病等特殊人群肺结核患者在抗结核治疗期间药物不良反应情况,为其临床调整用药提供相关依据,以降低特殊人群肺结核治疗中不良反应发生。方法由结核科专业医师查阅2007年1月至20l2年12月病例资料,包括住院病历、病程记录、服药记录、实验室检查等,回顾性分析特殊人群肺结核患者药物所致不良反应的发生情况。结果特殊人群肺结核患者抗结核治疗药物不良反应发生率达43.1%,显著高于非特殊人群的29.7%(P<0.05),特殊人群组不良反应出现的时间平均为24.3 d,显著早于非特殊人群组的33.7 d(P<0.05)。特殊人群97.7%的不良反应发生在服药后2个月内,而非特殊人群服药2个月内发生不良反应率为83.5%(P<0.05)。结论特殊人群肺结核患者抗结核治疗期间药物不良反应发生时间较早、发生率较高,特殊人群要加强不良反应监测。

Objective To investigate the adverse drug reactions associated with anti-tuberculosis treatment in special populations（children and elderly tuberculosis patients,as well as those with other chronic diseases）,and provide evidences for clinical use of drugs to prevent and reduce the adverse reactions during the treatment.Methods The data of cases from January 2007 to December 20l2 were reviewed,including medical records,progress notes,medication administration records,and laboratory tests,etc..Retrospective analysis was performed on the occurrence of adverse reactions caused by drugs in special populations of tuberculosis patients.Results The incidence rate of adverse reactions in special tuberculosis populations associated with anti-TB treatment was 43.1%,significantly higher than the 29.7% in non-special populations（P0.05）.The average time of occurrence of adverse reactions in special population group was 24.3 days,significantly earlier than the 33.7 days in non-special group（P0.05）.97.7% of the adverse reactions in special populations occurred within two months after drug aministration,compared to the 83.5% in non-special populations.（P0.05）.Conclusion Adverse drug reactions occur earlier at a higher rate in special populations of tuberculosis patients during anti-TB treatment,to which monitoring should be strengthened.