达比加群酯致出血不良反应国内外文献分析

Dabigatran-induced bleeding: analysis of literature at home and abroad

目的:分析达比加群酯出血不良反应的发生情况及临床特点,为合理用药提供参考。方法:检索达比加群酯2010年上市以来中国学术期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、Pubmed数据库收载的出血不良反应文献,进行统计分析。结果:达比加群酯出血不良反应的文献报道共45例次;其年龄分布以75岁以上年龄段居多(36例,80%);多发生在用药后31~90 d(13例,28.89%);累及的器官较多,以消化道多见(15例,33.33%);从治疗转归情况来看,1~7 d停止出血病例最多(18例,40.00%),死亡病例以入院2周内居多(10例,83.33%)。结论:临床合理使用达比加群酯的同时,应加强用药监测,以减少出血不良反应。

Objective:To analyze the general patterns and characteristics of bleeding induced by dabigatran,and provide reference for clinical medication.Methods:Bleeding cases of dabigatran reported by medical science journals at home and abroad were collected from CNKI,VIP,and PUBMED database from Oct.2010 to Jun.2018,and analyzed statistically.Results:A total of 45 ADR cases were identified and included in the analysis.Patients at the age of more than 75 years showed the highest incidence(n=36,80%).The period with the largest number of bleeding cases was 31 to 90 days after medication(n=13,28.89%).The bleeding involved a lot of organs among which the digestive tract had the highest frequency(n=15,33.33%).In terms of treatment outcome,most bleeding stopped within 1 to 7 days(n=18,40.00%).Among the 12 death cases,10 died within2 weeks after admission to hospital(83.33%).Conclusion:Clinicians should use dabigatran rationally and closely monitor its use to reduce the incidences of bleeding.