标准四化抗结核药物不良反应的临床分析

Clinical analysis of adverse reactions caused by four standard antituberculosis drugs

目的分析标准四化抗结核药物不良反应发生的特点和规律,有效预防不良反应的发生,避免严重不良事件的发生。方法选取2019年1月至2019年9月收治的499例肺结核患者,其中使用标准四化抗结核药物治疗者273例,根据临床表现及血生化检查,出现不良反应者共73例。对患者的基本情况、不良反应发生情况进行回顾性分析。结果73例抗结核药物所致不良反应患者中,男性(63.01%)多于女性(36.99%);20~29岁患者较多见(31.51%);利福平与吡嗪酰胺所致的不良反应发生率均为43.84%,不良反应主要累及消化系统,临床表现为肝功能异常,吡嗪酰胺导致肝功能异常更明显;其次为皮肤反应,主要表现为皮疹。结论在标准四化抗结核治疗过程中,不良反应与多种因素有关,如性别、生活习惯、药物代谢特点、季节性等,医护人员应重视及警惕不良反应的发生,注意合理用药,保障患者用药安全。

Objective To analyze the characteristics and rules of adverse drug reactions caused by four standard antituberculosis drugs,so as to effectively prevent the occurrence of adverse reactions and avoid the occurrence of serious adverse events.Methods A total of 499 patients with pulmonary tuberculosis treated from January 2019 to September 2019 were selected.Among them,273 cases were treated with four standard antituberculosis drugs,and 73 cases had adverse reactions according to clinical manifestations and blood biochemical tests.The patients'basic information and clinical manifestations of adverse reactions were retrospectively analyzed.Results In 73 cases of patients had adverse reactions caused by antituberculosis drugs,male(63.01%)was more than female(36.99%),and patients aged 20-29 years were more common(31.51%);the incidences of adverse reactions caused by rifampicin and pyrazinamide were both 43.84%,and the adverse reactions mainly affect the digestive system,which was manifested as liver dysfunction,and liver dysfunction caused by zinamide was more obvious;skin reaction were the next adverse reaction,and the main performance was skin reaction rash.Conclusion In the four standard antituberculosis drugs treatment,adverse reactions are related to many factors,such as gender,living habits,drug metabolism characteristics,seasonality,etc.Medical staff should attach importance to and be alert to the occurrence of adverse reactions,pay attention to rational drug use,and ensure the safety of drug use of patients.