阿奇霉素注射液引起肝功能异常的回顾性分析

Retrospective Analysis of Liver Dysfunction Induced by Azithromycin Injection

目的:调查我院住院患者使用阿奇霉素注射液后引起肝功能异常的病例,为促进阿奇霉素临床安全使用提供依据。方法:采用回顾性研究方法,调取我院2018~2019年使用阿奇霉素注射液患者的病历资料,收集患者基本信息、用药情况及用药期间肝功能变化,参照药品不良反应评价标准确定阿奇霉素引起肝功能异常病例,并对不良反应严重程度及相关指标、患者转归进行统计分析,对发生和未发生肝功能异常患者的相关指标进行比较。结果:共纳入179例静脉滴注阿奇霉素的病例,确定阿奇霉素引起肝功能异常6例,发生率为3.35%。6例均为轻度肝损伤(1级),好转4例(66.67%),未好转1例(16.67%),不详1例(16.67%)。发生和未发生肝功能异常患者比较显示,两组间合并用药数量和合并用药品种数差异有统计学意义(P<0.05),而年龄、性别、阿奇霉素用药天数等指标差异无统计学意义(P>0.05)。结论:阿奇霉素导致肝功能异常的发生率较高,重症者可致急性肝衰竭甚至死亡,因此使用阿奇霉素时应密切监测患者肝功能,保障患者用药安全。

Objective: To investigate the inpatients with liver dysfunction induced by azithromycin injection in our hospital to provide evidence for rational use of azithromycin. Methods: Retrospective study method was used,and the patients using azithromycin injection were selected from January 2018 to December 2019. The basic information,drug use and liver function of patients were analyzed. The related cases with liver dysfunction induced by azithromycin were identified according to the relevant criteria. The severity of adverse reactions,relevant indicators and outcomes of patients were analyzed. Results: Totally 179 patients with intravenous azithromycin were included in the study,and liver dysfunction occurred in 6 patients. The incidence rate was 3.35%. The patients with liver dysfunction were mild liver damage( Grade 1). The outcomes of patients were as follows: improved in 4 cases( 66.67%),unimproved in one case( 16.67%),and unknown in one case( 16.67%). The indicators between the liver dysfunction cases and cases without liver dysfunction were compared. The results showed that the differences between the number of combined drugs and the number of varieties of combined drugs were statistically significant( P< 0.05). There were no statistically significant differences in 12 relevant indicators such as age,gender and administration day of azithromycin( P>0.05). Conclusion: The liver dysfunction induced by azithromycin is with high incidence. Severe patients may cause acute hepatic failure or even death. Therefore,the changes of liver function should be monitored during the use of azithromycin in order to ensure the safety.