新型冠状病毒肺炎药物不良反应的临床分析

Clinical analysis of adverse drug reactions related to coronavirus disease 2019

目的分析3种新型冠状病毒肺炎药物导致的药物不良反应(adverse drug reaction,ADR)的临床特点,为临床安全用药提供参考。方法选择湘潭市中心医院2020年1月20日-3月5日收治的33例新型冠状病毒肺炎患者为研究对象,对抗病毒过程中发生ADR的患者临床资料进行回顾性分析,对患者性别、年龄、药物种类、联合用药、涉及的器官或系统及临床表现等信息进行总结分析。结果最终入组33例患者,共报告21例ADR。≥60岁患者的ADR发生率较高(80.0%)。临床表现以消化道症状最常见(66.7%)。ADR发生率以洛匹那韦/利托那韦+阿比多尔+利巴韦林三药联合使用最高(100.0%),其次为洛匹那韦/利托那韦+阿比多尔两药联合使用(85.7%)。阿比多尔及利巴韦林各导致1例严重ADR。结论针对新型冠状病毒肺炎患者应尽量避免2种及以上抗病毒药物联用,对高龄、重型/危重型及过敏体质的患者应加强药学监护。

Objective To analyze the clinical characteristics of adverse drug reaction(ADR)caused by 3 kinds of coronavirus disease 2019 drugs,and provide a reference for clinical safe medication.Methods A total of 33 patients with coronavirus disease 2019 admitted to Xiangtan Central Hospital from January 20 to March 5,2020 were selected as the research objects.The clinical data of patients with ADR during the antiviral process were analyzed retrospectively.The patients’gender,age,type of medication,combination medication,organs or systems involved,and clinical manifestations were summarized and analyzed.Results A total of 33 patients were enrolled.A total of 21 cases of ADR were reported.The incidence of ADR is higher in patients older than 60 years(80.0%).The most common clinical manifestations are digestive tract symptoms(66.7%).The incidence of ADR is highest in the combination of lopinavir/ritonavir+arbidol+ribavirin(100.0%),followed by the combination of lopinavir/ritonavir+arbidol(85.7%).Abidol and ribavirin each caused 1 case of severe ADR.Conclusion For patients with coronavirus disease 2019,the combination of two or more antiviral drugs should be avoided,and pharmaceutical monitoring should be strengthened for elderly,severe/critical and allergic patients.