84例伏立康唑不良反应分析

Analysis of 84 Cases of Adverse Reactions Induced by Voriconazole

目的收集和分析伏立康唑不良反应(ADR)报告,为临床安全合理使用伏立康唑提供参考。方法收集2013—2015年浙江省各家医院上报的伏立康唑ADR共84例,按患者性别、年龄、给药方式、ADR发生时间、联合用药情况、累及的器官或系统、转归等进行统计分析。结果在84例伏立康唑ADR报告中,男性多于女性,年龄22~95岁,主要集中在60岁以上(占75.00%)。由静脉滴注引起46例,占54.76%,由口服引起31例,占36.90%,涉及两种给药方式7例,占8.33%。ADR在服药后立即或当天发生20例,占23.81%,2~10 d内发生36例,占42.86%。ADR临床表现主要为消化系统损伤,占31.58%,以肝功能异常为主,主要由口服引起;其次是视觉障碍,占17.54%,主要由静脉滴注引起;神经损伤比例为16.67%,全身反应占11.40%。结论临床应加强对伏立康唑ADR的宣教、识别和预防,有条件的医院可以进行血药浓度监测,实现个体化给药,以避免或减少ADR的发生。

ObjectiveTo analyze adverse reaction of voriconazole in Zhejiang province,and provide reference for safe and rational clinical use of it.MethodsEighty four cases of voriconazole ADR reported from2013to2015were analyzed in terms of sex,age,mode of administration,time of ADR,combined drug use,organ or system involvement,outcome,etc.ResultsIn the84cases of voriconazole ADR,the number of males was higher than that of females,aged22to95years old,and most cases were more than60years of age,accounting for75.00%.Forty six cases were caused by intravenous infusion,accounting for54.76%,31ADR cases were caused by oral administration,accounting for36.90%,7ADR cases were caused by intravenous infusion and oral administration,accounting for8.33%.In20cases,ADR occurred immediately or on the administration day,accounting for23.81%,and ADR in36cases occurred2to10days after the administration,accounting for42.86%.The clinical manifestations of ADR were mainly digestive system injury,accounting for31.58%,and the liver function abnormality was most common,mainly caused by oral administration;visual impairment was the second,accounting for17.54%,mainly caused by the intravenous infusion;the proportion of nervous system injury was16.67%,and the proportion of systemic reactions accounted for11.40%.ConclusionDuring the period of clinical use,doctors,pharmacists,and nurses should strengthen the propaganda and education,recognition and prevention of voriconazole's ADR.The qualified hospitals may monitor the blood concentration and achieve individualized administration,to reduce the occurrence of ADR.