治疗新冠肺炎抗病毒药物潜在相互作用横断面分析

A Cross-sectional Analysis of Potential Interactions with Antiviral Drugs in the Treatment of COVID-19

目的调查某院治疗新型冠状病毒肺炎抗病毒药物与其他药物之间潜在相互作用(potential antiviral drug-drug interactions, paDDIs)发生率和危险因素,探讨减少paDDIs发生的管理策略,保障患者用药安全。方法筛选某院2020年1~4月新型冠状病毒肺炎病例,审核其中paDDIs,采用Logistic回归分析分析危险因素,制定调整建议。结果纳入分析的病例中20.75%发生paDDIs,其中年龄(P<0.05)、药品品种数(P<0.05)、病情程度(P<0.05)是影响病例paDDIs发生的危险因素。审核发现135条paDDIs, X、D、C级paDDIs级分别为10条(7.41%)、75条(55.56%)、28条(20.74%),涉及24种药物配对;其中影响发生X级paDDIs的主要因素为药品品种数(P<0.05)和病情程度(P<0.05),影响发生D级paDDIs主要因素的为使用药品种类(P<0.05)和病情程度(P<0.05),影响发生C级paDDIs的主要因素为药品品种数(P<0.05)和年龄(P<0.05)。结论新冠肺炎患者存在paDDIs风险,通过筛选paDDIs医嘱,发掘危险因素,针对性制定合理用药建议及药品管理策略,为可能发生的下一波疫情做好充分准备。

OBJECTIVE To investigate the incidence and risk factors of potential antiviral drug-drug interactions(pADDIs) for COVID-19 treatment in a hospital, formulate the management measures to reduce the incidence of paDDIs, and ensure the drug safety of patients. METHODS All novel coronavirus pneumonia patients in a hospital were included from January to April 2020. The antiviral pADDIs were evaluated by the MCDEX Database. Logistic regression analysis was used to analyze risk factors of pADDIs to make recommendations for drug adjustment. RESULTS Of the included patients, 20.75% had occured pADDIs(n=429). Age(P<0.05), the number of drugs(P<0.05) and severity of disease(P<0.05) were the risk factors affecting the occurrence of pADDIs. We found 135 pADDIs, involved24 drug pairs, 10(7.41%), 75(55.56%) and 28(20.74%) of pADDIs of grade X, D and C respectively. The main factor affecting the occurrence of grade X pADDIs were the number of drugs(P<0.05) and severity of disease(P<0.05). The main factor affecting the occurrence of grade D pADDIs were the type of drugs used(P<0.05) and severity of disease(P<0.05). The main factor affecting the occurrence of Grade C pADDIs were the number of drugs(P<0.05) and age(P<0.05). CONCLUSION Patients with COVID-19 are at risk for pADDIs. By monitoring the pADDIs in prescriptions and finding the risk factors, pharmacists can formulate a reasonable medication recommendations and management measures to make full preparations for the next wave of possible outbreak.