注射用血栓通疑似过敏反应影响因素分析:基于7家医疗机构的真实数据

Analysis on influencing factors for suspected allergic reactions to Xueshuantong Injection:based on real data from 7 medical institutions

目的探讨注射用血栓通疑似过敏反应的影响因素,为临床合理用药提供参考。方法收集7家医院2015年6月至2019年2月有注射用血栓通使用记录的住院病历,采用处方序列分析得到注射用血栓通疑似过敏反应患者78例,使用倾向评分匹配法按性别、年龄、住院科室进行1∶4匹配得到对照组研究对象312例;采用条件Logistic回归分析溶媒、过敏史、单次给药剂量以及联合用药对疑似过敏反应的影响。结果两组在溶媒、过敏史及单次给药剂量上差异没有统计学意义(P>0.05),部分药品在联合用药上差异有统计学意义(P<0.05),注射用血栓通与奥美拉唑(OR=3.280,P=0.0076)、泮托拉唑(OR=3.103,P=0.0028)、甘露醇(OR=4.017,P=0.0004)、氨甲环酸(OR=2.895,P=0.0161)、利多卡因(OR=4.401,P=0.0013)、氨溴索(OR=3.607,P=0.0036)6种药物联合使用可能会增加患者发生过敏反应的风险。结论注射用血栓通与奥美拉唑、泮托拉唑、甘露醇、氨甲环酸、利多卡因和氨溴索6种药物联合使用可能会增加患者发生过敏反应的风险。

Objective To investigate the influencing factors of suspected allergic reactions caused by Xueshuantong Injection,and to provide reference for clinical rational drug use.Methods From June 2015 to February 2019,the medical records of the inpatients with the use of Xueshuantong Injection from 7 hospitals were collected.And 78 patients with suspected allergic reaction to the injection were obtained by prescription sequence analysis.Another 312 subjects sampled at 1∶4 ratio of gender,age and inpatient department using propensity score matching were assigned into the control group.Conditional logistic regression was used to analyze the effects of solvent,allergy history,single dose and combination on suspected allergic reaction.Results There were no significant differences in the solvent,allergy history and single dose between the 2 groups(P>0.05).But statistical difference was seen in the combination of some drugs(P<0.05),such as omeprazole(OR=3.28,P=0.0076),pantoprazole(OR=3.103,P=0.0028),mannitol(OR=4.017,P=0.0004),tranexamic acid(OR=2.895,P=0.0161),lidocaine(OR=4.401,P=0.0013)and ambroxol(OR=3.607,P=0.0036).Combination of the above drugs may increase the risk of allergic reactions.Conclusion The combination of Xueshuantong Injection with omeprazole,pantoprazole,mannitol,tranexamic acid,lidocaine and ambroxol may increase the risk of allergic reactions in the patients.