甲巯咪唑药品不良反应病例文献分析

Literature Analysis on Adverse Reaction Case Reports Induced by Thiamazole

目的:探讨甲巯咪唑致不良反应的临床特点及注意事项。方法:基于我院发现甲巯咪唑致间质性肺炎罕见病例,检索CNKI、万方、VIP、Pub Med数据库有关甲巯咪唑不良反应病例文献报道,重点分析发生不良反应患者的性别、年龄、临床表现、累及系统等,并评价不良反应与甲巯咪唑的关联性。结果:收集文献68篇共91例不良反应纳入分析。甲巯咪唑不良反应发生女性比例远大于男性,约3∶1,与甲状腺功能亢进发病率一致。用药剂量多为30 mg·d-1,不良反应发生时间短至1 d,最长为3年,多在1个月之内。不良反应表现涉及7大系统,包括血液系统、骨与关节、消化、呼吸及内分泌系统等,严重不良反应为重度粒细胞缺乏致死亡。Naranjo's量表关联性评价结果提示,除7例不良反应可疑外,其他均与甲巯咪唑相关。结论:甲巯咪唑导致的不良反应不容忽视,在临床使用中要及时监测血常规、肝功能等,确保患者安全用药。

Objective： To investigate the clinical characteristics and announcements of adverse drug reactions （ADRs） induced by thiamazole. Methods ： Base on a case of interstitial pneumonia induced by thiamazole in our hospital, literature about ADRs due to thiamazole were searched from CNKI, Wanfang, VIP, PubMed database. The gender and age of patients with ADRs, clinical manifestations, system-organ damages will be analyzed. Results ：67 literatures were collected; a total of 91 cases were included in the analysis. The proportion of ADRs occurring was higher in women than men, the ratio was about 3 ： 1. The most dosage was 30 mg · d^-1. ADRs occurred between 1 day to 3 years after medications, most within 1 month. ADRs involved 7 system-organs, including the blood system, bone and joint, digestive system, respiratory and endocrine system and so on. The most serious adverse reaction was death caused by severe agranulocytosis. Naranjo＇s ADR probability scale was used to evaluate relevance. Except 7 cases of suspected, the other ADRs were associated with thiamazole. Conclusion：There are more attention should pay to the ADRs due to thiamazole. The blood and liver function should be monitored during medication, to make sure the safety of patients.