二巯丙磺钠注射液治疗肝豆状核变性致药疹的影响因素分析

Analysis of factors for drug rash caused by sodium dimercaptopropane sulfonate injection in hepatolenticular degeneration patients

目的:探讨二巯丙磺钠注射液驱铜治疗肝豆状核变性致药疹的影响因素。方法:采用医院集中监测方法,对某三甲医院2015年6月-12月接受二巯丙磺钠注射液排铜的肝豆状核变性患者进行不良反应监测,收集相关信息,使用Microsoft Excel录入以及管理数据,进行单因素及多因素Logistic回归分析。结果:600例患者纳入研究,69例患者出现不良反应,均为药疹,发生率为11.50%。经多因素Logistic回归分析显示,致药疹发生的4个因素,包括药物过敏史(OR=4.518;95%CI,1.150~15.037,P=0.030),红细胞值(OR=1.422;95%CI,3.283~12.465,P=0.049),血清肌酐值(OR=1.485;95%CI,1.093~4.372,P=0.034),出现药疹时药物的使用疗程(OR=0.420;95%CI,0.018~10.066,P=0.034)。结论:药物过敏史、红细胞值偏低、血清肌酐值偏高、出现药疹时药物使用的第1和第2疗程对二巯丙磺钠注射液致药疹的发生有显著意义,临床药师可针对具有上述因素的患者加强药学监护,安全、有效使用二巯丙磺钠注射液。

OBJECTIVE To investigate the influence factors for drug eruption induced by soudium dimercaptopropane sulfnate injection in patients with anti-copper hepatolenticular degeneration.METHODS From June to December in 2015,totally600 patients with hepatolenticular degeneration treated by sodium dimercaptopropane sulfonate injection were enrolled.Relevant data were collected and managed by using Microsoft Excel,and analyzed by using univariate and multivariate logistic regression analysis.RESULTS Of 600 patients,69 patients had drug eruptions,accounting for 11.50%.Multivariate logistic regression analysis showed 4 factors of drug eruption,including the history of drug allergy（OR=4.518;95% CI,1.150-15.037,P=0.030）,red blood cell count（OR=1.422;95% CI,3.283-12.465,P=0.049）,serum creatinine（OR=1.485;95% CI,1.093-4.372,P=0.034）,treatment course with drug eruption（OR=0.420;95% CI,0.018-10.066,P=0.034）.CONCLUSION The history of drug allergy,low red blood cell count,high serum creatinine,and cycle 1 or 2 treatment course have clinical significance to drug of sodium dimercaptopropane sulfonate injection.Clinical pharmacists can enhance pharmaceutical care for patients with above factors for safe and effective use of sodium dimercaptopropane sulfonate injection.