肝硬化腹水患者潜在药物相互作用的横断面研究

Cross-sectional Study of Potential Drug-drug Interactions in Cirrhosis Patients with Ascites

目的:描述潜在药物相互作用(pDDIs)在肝硬化腹水住院患者药物医嘱中发生的危险因素和类型,并分析其临床意义。方法:收集了某院2018年10~12月所有肝硬化腹水住院患者的药物医嘱,以Micromedex和Medscape药物相互作用数据库为基础鉴别pDDIs并对其严重程度进行评估,将发生pDDIs的患者分为两组(发生1次及以下pDDIs为A组,发生2次及以上pDDIs为B组),分析pDDIs的相关危险因素。结果:共纳入187例患者,审核3648条药物医嘱,含pDDIs医嘱420条,其中严重程度为禁忌和严重比例为36.2%。A、B两组患者的平均年龄、使用药物品种数和平均住院时间差异有统计学意义(P<0.05),提示这几项可能是pDDIs的相关因素。结论:肝硬化腹水住院患者医嘱的pDDIs发生率较高,临床药师和医生应关注高龄、住院时间长、合并用药品种多的患者,评估和干预pDDIs,保障用药安全。

Objective:To describe the prevalence of potential drug-drug interactions(pDDIs),as well as evaluating them in relation to clinical impact in cirrhosis patients with ascites.Methods:The medical advice of patients with cirrhotic ascites in a hospital from October to December in 2018 was collected.The pDDIs were identified based on the Micromedex and Medscape database drug interactions and severity of pDDIs were assessed.Patients with pDDIs were divided into two groups,pDDIs occurring once or less were considered group A,twice or more considered group B.The related risk factors were analyzed.Results:A total of 187 patients were enrolled in this study.There were 3648 medication and 420 potential pDDIs were identified and analyzed.The prevalence of contraindicated and major severity pDDIs was 36.2%.There were statistically significant differences in average age,number of drugs used and average length of stay between group A and B(P<0.05),it indicated that these factors may be related to pDDIs.Conclusion:The incidence of pDDIs in cirrhosis patients with ascites is high.Clinical pharmacists and physicians should pay attention to the patients with advanced age,long hospital stay,combination of drug varieties,and assess and intervene pDDIs to ensure drug safety.