上海儿童医学中心华法林药物相互作用5年数据分析

Five-years Data Analysis of Warfarin Drug Interactions in Shanghai Children’s Medical Center

目的:分析儿童患者华法林治疗过程中药物相互作用(DDIs)情况,为华法林合理用药提供依据。方法:基于药物相互作用Lexi-Interaction^(TM)软件筛选与华法林具有明显DDIs的药物及其安全性分级信息;收集20142018年上海交通大学医学院附属上海儿童医学中心接受华法林治疗的病例资料,分析使用华法林的DDIs情况。结果:与华法林存在DDIs的药物中,安全性分级为X级的有8种,D级有41种。433例使用华法林的患儿主要诊断为先天性心脏病(61.4%)和川崎病(18.2%),其中324例(74.8%)合并使用与华法林存在DDIs的药物;同时合并使用存在13种DDIs药物的患儿有277例。所用与华法林存在DDIs的药物有11种,均为D级。5年间,合并使用与华法林存在DDIs药物情况共发生715例次,其中最多的是非甾体抗炎药,其次是镇静催眠药。结论:儿童患者应用华法林时,具有药物相互作用的药物同时使用的情况应当注意。

Objective:To analyze the drug interactions(DDIs)during warfarin treatment in children to provide reference for the rational use of warfarin.Methods:Based on the drug interaction software Lexi-Interaction^(TM),the drugs with obvious DDIs with warfarin and their safety classification information were screened.The case data of warfarin used in children in Shanghai Children’s Medical Center affiliated to Shanghai Jiao Tong University School of Medicine from 2014 to 2018 were collected,and the DDIs were analyzed.Results:Among the drugs that interacted with warfarin,8 drugs were at grade X and 41 drugs at grade D.A total of 433 children with warfarin treatment were selected.Among them,the main diagnosis was congenital heart disease(61.4%)and Kawasaki disease(18.2%).Totally 324 cases(74.8%)used the drugs with DDIs with warfarin.There were 277 cases treated with 1-3 drugs with DDIs at the same time.There were 11 drugs with DDIs with warfarin,all of which were at grade D.In the past five years,there were 715 cases of DDIs combined with warfarin,and the most common drugs were NSAIDs followed by sedative hypnotics.Conclusion:When warfarin is used in pediatric patients,attention should be paid to the use of drugs with DDIs with warfarin.