头孢硫脒不良反应文献分析及原因探讨

Literature analysis and reason investigation for adverse reactions of cefathiamidine

目的:调查分析注射用头孢硫脒近年来的不良反应(ADR)发生情况,探讨ADR发生的原因,为临床合理用药提供指导。方法:检索中国知网(CNKI)、万方医学网数据库中2001-2015年关于头孢硫脒的ADR病例,从ADR发生的人群分布、临床表现等方面进行统计、分析。同时从头孢硫脒的化学结构、与输液配伍的稳定性及降解产物三个方面对头孢硫脒ADR进行原因分析。结果:搜集到符合条件的文献15篇,共有98例患者。9岁以下的儿童共40例,ADR发生率最高。ADR可累及消化系统、神经系统、呼吸系统、循环系统、皮肤及其附件。头孢硫脒与部分输液配伍稳定性较差,随着放置时间的增加,可产生具有过敏源性的杂质,这可能是其ADR发生的原因之一。结论:临床使用头孢硫脒时应监测ADR,ADR发生的原因还需要进一步研究。

OBJECTIVE To analyze the occurrence of adverse reactions（ADRs）of cefathiamidine for injection in recent years,discuss the reasons for ADRs and provide information for reasonable drug use in clinical practice.METHODS Literatures were retried from CNKI database to collect literatures about ADRs induced by cefathiamidine for injection published from2001 to 2015.Patient age,clinical manifestations and ADRs were analyzed statistically.The chemical structure,compatible stability with infusions and the degradation compounds were analyzed to find the reasons inducing ADRs.RESULTS Fifteen literatures and 98 patients were collected,40 patients younger than 9 years old were involved in ADRs,with the highest incidence.Main ADRs involved digestive,nerves,respiratory and circulatory system and skin and its appendages.The reasons inducing ADRs were closely associated with allergenic cefathiamidine polymer produced in the metabolic process and the impurities caused by the compatible stability with infusions and long holding time or high concentrations.CONCLUSION More attentions should be paid to ADRs in clinical practice and the reasons inducing ADRs need to be further studied.