他汀类调脂药与其他药物联用致不良反应临床分析

Clinical Analysis of Adverse Drug Reaction Induced by Statins Combined with Other Drugs

目的分析他汀类药与其他药物联用时所致不良反应的特点,为临床合理用药提供参考。方法回顾性分析医院2011年6月至2016年6月采用他汀类药与其他药物联用导致不良反应的78例患者的临床资料。结果不良反应主要表现为肌肉毒性、肝毒性、消化系统不适、呼吸系统不适等,以肌肉毒性、肝毒性最常见;其中横纹肌溶解症所占比例为20.51%,显著高于其他不良反应(P<0.05);辛伐他汀和阿托伐他汀所致不良反应发生率分别为44.87%和28.21%,显著高于其他他汀类药物(P<0.05);他汀类药物与降压药、抗心肌类药物联用时不良反应发生率(30.77%)最高,与贝特类调脂药联用时不良反应发生率(20.51%)次之。结论他汀类药物尤其是辛伐他汀和阿托伐他汀与降压、抗心肌、调脂等药物联用时不良反应的发生率相对较高,以肝毒性、肌肉毒性为主要临床表现,临床用药中应根据患者的临床特征和药物类型制订规范、合理的用药方案,最大限度地减少不良反应的发生。

Objective To investigate the features of adverse drug reaction（ADR） induced by statins combined with other drugs,in order to provide reference for clinical rational, drug use. Methods The clinical data of 78 patients with ADRs caused by statins combined with other drugs in the hospital from June 2011 to June 2016 were reviewed and analyzed. Results The main manifestations of the ADRs were muscle toxicity,liver toxicity,digestive discomfort,respiratory discomfort,et al,in which muscle toxicity and liver toxicity were the most common ADRs. The incidence rate of rhabdomyolysis was 20.51% ,which was significantly higher than that of the other ADRs （P 〈 O. 05）. The incidence rates of ADR induced by Simvastatin and Atorvastatin were 44. 87% and 28.21% ,respectively,which were significantly higher than the other statins （P 〈 0.05）.The incidence of ADR was the highest（30.77% ） when the statins combined with antihypertensive drugs and anti-myocardial drugs, the incidence of ADR was the second（20.51% ） when statins combined with lipid- lowering drugs. Conclusion The ADR rate is relatively high when statins, especially Simvastatin and Atorvastatin combined with anti- hypertensive, anti- myocardial and lipid- lowering drugs, and the main manifestations of the ADRs are liver toxicity and muscle toxicity. The standardized and rational medication regimen should be made based on the clinical characteristics of patients and the type of drug in the clinical use of statins,in order to minimize the occurrence of the ADRs.