呋塞米相关的胰酶异常模块研发及自动监测研究

Research on the development of the new automatic surveillance module and furosemide-associated pancreatin abnormality

目的 :拓展"医疗机构ADE主动监测与智能评估警示系统"功能模块,探索利用新模块实现呋塞米相关胰酶异常自动监测的可行性和关键要素。方法:基于成熟技术路线,研发"胰酶异常"新模块,并采用回顾性分析方法,利用新模块对我院2016年1–6月使用呋塞米住院患者进行自动监测,分析呋塞米相关胰酶异常的发生规律及系统效能。结果:共计筛查病例6832例次,纳入2356例,报警179例次,其中阳性45例次,阳性报警率为25.14%,发生率1.91%。疑似急性胰腺炎病例9例次,发生率0.38%。纳入可评价的排除病例前后测算发生率无明显差异。ADR多发生于用药后3 d内,高剂量与低剂量给药均可发生ADR。结论:通过合理设置事件配制器参数,"胰酶异常"新模块可高效、准确监测呋塞米相关胰酶异常的发生特征和危险因素,为临床诊断提供依据。呋塞米短期给药即可引起胰酶异常,临床用药过程中应密切监测,做好风险防控。

Objective： To expand the module of medical organization ADE active surveillance and intelligence assessment alarming system, and explore the feasibility and key factors of utilizing the new module to actively monitor the furosemide- associated pancreatin abnormality. Methods： Adopting analytical method, inpatients taking the target drugs from January to June in 2016 were monitored and the positive predictive value of the system and the occurrence regulations were analyzed, supplemented by artificial screening to verify the setting rationality of the exclusive indexes. Results： 2356 cases were screened from 6832 cases, and 179 were alarming cases, among which 45 were the positive cases, with the positive alarming rate of 25.14% and the occurrence rate of 1.91%. Nine were the suspected acute pancreatitis cases, with the occurrence rate of 0.38%. The occurrence rates before and after enrolling the evaluable excluded cases showed no obvious difference. ADR mostly occurred within 3 days after medication, and both high dose and low dose could result in the occurrence of ADR. Conclusion： The new module can effectively and accurately measure the characteristics and risk factors of the furosemide-associated pancreatin abnormality through reasonably setting the event configurator parameters, which can provide foundation for clinical diagnosis and has excellent application prospect.