非甾体消炎药相关药品不良反应报告分析

Adverse reactions of non-steroid anti-inflammatory drugs

目的分析非甾体消炎药（NSAIDs）相关药品不良反应（ADR）发生情况及特点，为临床NSAIDs的合理使用提供参考依据。方法收集2015年2月至2016年2月浙江大学医学院附属邵逸夫医院门诊上报的82例患者疑似ADR报告，剔除非ADR后得到79例，再筛选出因使用NSAIDs出现ADR的患者23例。对这23例患者的ADR进行回顾性分析。结果NSAIDs引起ADR发生以〉40岁中老年患者为主，占82．6％（19／23）；男性与女性发生ADR的比例是1：1．3。所有患者均口服给药，停药后症状均好转，胃肠道反应（16例）为NSAIDs最常见的不良反应，主要表现为恶心、呕吐、上腹疼痛、腹泻。23例发生ADR患者中联合使用NSAIDs与中成药占比较高，达65．2％（15／23）。23例患者中2例发生严重ADR，涉及药物为双氯芬酸缓释片和二氟尼柳片，累及器官分别是皮肤和胃肠道。结论NSAIDs引起ADR发生以〉40岁中老年患者为主，最常见不良反应为胃肠道反应，在临床使用时需要考虑患者年龄、胃肠道的耐受性等因素，合理选用药物能减少ADR的发生。

Objective To analyze characteristics of adverse drug reaction （ADR） of non-steroid anti- inflammatory drugs（NSAIDs） and to provide reference for clinical rational drug use. Methods Eighty-two cases of suspected ADR were reported from outpatients in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University from February 2015 to February 2016 ; 23 cases of ADR induced by NSAIDs were selected for retrospective analysis. Results NSAIDs-induced ADR mainly occurred in patients over 40 years of age [ 82.6% （ 19/23 ） ] ; the ratio of ADR in males and females was 1 ： 1.3. All patients were orally administered; the symptoms were alleviated after drug withdrawal. Xixteen patients had gastrointestinal reaction that manifested as nausea, vomiting, epigastric pain and diarrhea. Fifteen patients （65.2%） took NSAIDs in combination with Chinese patent medicines. Severe ADR occurred in 2 patients who had dielofenac sustained-release tablets or diflunisal tablets, manifesting as severe skin injury and gastrointestinal reaction. Conclusions NSAIDs-induced ADR mainly occurred in patients over 40 years of age, the main ADR was gastrointestinal reaction. Age, gastrointestinal tolerance and rational drug use should be considered in patients who take NSAIDs to avoid ADR.