某关节病专科医院301例药品不良反应报告分析

Analysis of 301 Cases of Adverse Drug Reactions in a Special Hospital of Joint Diseases

目的：了解某关节病专科医院药品不良反应（ADR）发生特点，为临床合理用药提供参考。方法： 采用回顾性分析方法，对2010～2012年本院上报的ADR，按患者性别、年龄、给药途径、涉及药品种类、ADR累及器官或系统、临床表现进行统计分析。结果：301例ADR中，女性217例（71.1%），男性87例（18.9%）；50～59岁81例（构成比26.9%）；不同给药途径中口服最多；导致ADR的可疑药品前3类分别是疾病缓解抗风湿药、解热镇痛抗炎药、抗菌药；ADR累及器官或系统以胃肠系统损害为主，其次为皮肤及附件损害和肝胆系统损害；ADRs主要临床表现是恶心、呕吐、腹泻、皮疹、瘙痒、肝功能异常,有1例死亡。结论：应重视疾病缓解抗风湿药和解热镇痛抗炎药导致的ADR，服药期间注意患者有无胃肠系统或皮肤及附件不适，可定期监测肝功能和血常规，以减少或避免肝功能损害和白细胞减少等严重ADR的发生。

Objective：To investigate the characteristics of adverse drug reactions（ADRs） in a joint diseases special hospital in order to provide reference for rational use of drugs. Methods： The ADRs from 2010 to 2012 were statistically analyzed retrospectively in respect of the gender and age of patients, routes of administration, categories of ADR inducing drugs, organs or systems involved in ADRs and clinical manifestations.Methods：217 （71.1%） the 301 cases were female and 87（18.9%） cases were male.The incidence rate of ADRs from the age of 50 years to 59 years （81 cases,26.9%） was higher. The most common route of administration was oral administration（218 cases, 72.4%）. Diseases modifying anti rheumatic drugs were more common （79 cases, 26.2%）, followed by antipyretic analgesic and anti inflammatory drugs （ 72cases, 23.9%） and antibacterial drugs （44 cases,14.6%）. The most common involved organs/systems of ADRs were gastrointestinal system disorders（103 cases, 34.2%）, followed by skin and appendages disorders （72, cases 23.9%）and liver and biliary system disorders（32 cases,10.6%）. Nausea , vomiting, diarrhea, rash, itching and abnormal liver function were the most common clinic manifestations, and there was 1 case of death. Conclusion：More attention should be paid to the ADRs of disease modify antirheumatic drugs and antipyretic analgesic anti inflammatory drugs, to the gastrointestinal problems and skin and appendage disorders. The liver function and routine blood test should be regularly followed up in order to reduce or avoid the occurrence of serious ADRs such as liver function lesionand leukocytopenia.