真实世界中不同疗程使用疏血通注射液对肝肾功能影响的分析

Analysis of real-world use different treatment Shuxuetong injection effects on liver and kidney function

目的：了解真实世界中,超疗程使用疏血通注射液对肝肾功能是否有影响。方法：以全国18家三级甲等医院的HIS为数据来源,从中选择使用疏血通注射液、年龄在18-80岁、使用疏血通前7 d内和停药后7 d内均至少具有1次谷草转氨酶、或谷丙转氨酶、或肌酐、或尿素氮的测定值者作为研究对象,将用药天数是否超过14 d为依据,分为超疗程组和正常疗程组,以理化指标达到正常范围上限的200%定义为异常。采用倾向性评分法,平衡已知的混杂因素,并比较2组间肾功能发生异常的差异。结果：超疗程组与正常疗程组比较,导致谷丙转氨酶、谷草转氨酶、肌酐、尿素氮指标异常变化的可能性相同,无统计学差异。结论：基于现有数据,未发现＂超疗程使用疏血通对肝肾功能有损害＂的情况,但临床中仍要坚持中病即止原则,不可随意延长疗程,防止长期用药。

Objective：To understand the real world,the use of ultra- treatment Shuxuetong injection on liver and kidney functions are affected.Method：The 18 hospitals of the country＇s HIS data sources from which to choose to use Shuxuetong injection,between the ages of 18 to 80 years,using Shuxuetong and the first seven days after discontinuation of at least 7 days has once aspartate aminotransferase or alanine aminotransferase,or creatinine or blood urea nitrogen were measured value as a research object,the number of days of medication is based on more than 14 days,divided into treatment group and the normal course of super-group to reach the normal range of physical and chemical indicators 200%of the upper limit is defined as abnormal.Using the propensity score method,balance the known confounding factors,differences in the occurrence of abnormal renal function and compared between the two groups.Result：The treatment group and the normal course of super-group,resulting in alanine aminotransferase,aspartate aminotransferase,creatinine,urea nitrogen equally likely targets abnormal changes,no statistically significant difference.Conclusion：Based on the available data did not find ＂super treatment using Shuxuetong damage the liver and kidney function＂ the situation,but the clinical disease lasts insist on the principle can not be arbitrarily extended treatment to prevent long-term medication.