68例新型冠状病毒肺炎患者治疗药品不良反应分析

Analysis of Adverse Drug Reactions in 68 Patients with COVID-19

目的分析华中科技大学同济医学院附属同济医院(简称同济医院)新型冠状病毒肺炎患者治疗药物不良反应(ADR)的发生特点,为临床合理用药提供参考。方法回顾性分析同济医院2020年2—5月收治的68例新型冠状病毒肺炎患者的ADR报告,按患者性别、年龄、新的/严重的比例、涉及的怀疑药品、累及器官和(或)系统、临床表现、关联性评价及转归情况进行分析。结果不良反应构成比女性高于男性,主要发生在61~80岁人群,新的、严重的ADR 35例,占51.47%。引发ADR的药物前三位是抗病毒药物(32例,占47.06%),免疫抑制剂和抗感染药物(各4例,均占5.88%)。68例ADR报告中,累及器官或系统合计80例次,消化系统损害最多(37例,占46.25%),其次为皮肤损害(17例,占21.25%)。结论新型冠状病毒肺炎患者治疗药物发生ADR的主要原因是超说明书用药,老年患者治疗用药更易发生ADR。超说明书和老年人用药临床应加强监测,降低用药风险,确保患者用药安全。

Objective To investigate the characteristics of adverse drug reactions(ADR)in patients with COVID-19 in Tongji hospital,Tongji medical college,Huazhong university of Science and Technology(Tongji hospital)and provide references for rational drug use in clinic.Methods Using the method of retrospective analysis,the ADR report of 68 cases with COVID-19 reported by Tongji hospital from February 2020 to May 2020 were analyzed in terms of sex,age,proportions of new/serious cases,involved drugs,organs/system injury,clinical manifestations,correlation evaluation and outcomes.Results The constituent ratio of ADR was higher in female than in male.Cases of ADR were mainly in the group of 61-80 years old,of which 35 cases(51.47%)were new and serious.The top three drug types causing ADR were antiviral drug with 32 cases(47.06%),immunosuppressants and anti-infective drugs with 4 cases(5.88%),respectively.Organs and system related ADR occured in a total of 80 cases.The most common organ/system injury involved was digestive system with 37 cases(46.25%),followed by skin injury with 17 cases(21.25%).Conclusion Off-label drug uses contributed to the adverse reactions caused by drugs used in the treatment of COVID-19,and the elderly patients with COVID-19 were more susceptible to ADR.Monitoring should be strengthened in off-label drug use and drug use in the elder to reduce the risk of drug use and ensure the safety.