某院189例肿瘤患者药品不良反应及相关性分析

Adverse Drug Reaction of 189 Patients with Tumor in a Hospital and Its Correlation Analysis

目的为临床合理使用抗肿瘤药物及辅助药物,加强药学监护提供参考。方法从国家药品不良反应监测系统中获取某院2014年至2020年药品不良反应(ADR)报告,筛选出原患疾病为肿瘤且使用抗肿瘤药物及辅助用药的病例,统计患者年龄、性别、用药类别、ADR分布、ADR发生时间和严重程度,并分析相关性。结果189例患者中,女性(56.61%)较多,年龄以51~60岁占比最大(30.69%);ADR涉及8个类别、34种药品,植物来源类占比最大(6个品种,62例次,32.80%),常见品种为紫杉醇及多西他赛的注射剂型;ADR累及系统/器官以血液系统最多见(107例,56.61%),表现为粒细胞缺乏症、骨髓抑制、白细胞减少等;76.72%的ADR发生在用药24h后。ADR发生时间与用药类别相关(P<0.05);ADR严重程度与患者年龄、体质量、ADR发生时间、用药类别相关(P<0.05)。结论加强对抗肿瘤药物及辅助用药ADR的监测,了解其ADR的特点和规律,做好预防工作,可为临床安全、合理、个性化用药提供参考。

Objective To provide a reference for clinical rational use of anti-tumor drugs and adjuvant drugs and strengthening pharmaceutical care.Methods The adverse drug reaction(ADR)reports in a hospital from 2014 to 2020 were obtained from the National Adverse Drug Reaction Monitoring System to screen the cases with tumor as the original disease treated with anti-tumor drugs and adjuvant drugs.The patients'age,gender,medication category,ADR type,occurrence time and severity of ADR were counted,and the correlation between the occurrence time and severity of ADRs and various influencing factors was analyzed.Results Among the 189 patients,most of them were female(56.61%)and aged from 51 to 60 years(30.69%).ADRs involved eight categories and thirty-four kinds of drugs,and the plant-derived categories accounted for the largest proportion(six varieties,62 cases,32.80%).The common varieties were injection dosage forms of paclitaxel and docetaxel.The most common system/organ involved in ADRs was the blood system(107 cases,56.61%),which was characterized by agranulocytosis,bone marrow suppression,leucopenia and so on.Precisely 76.72%of ADRs occurred at 24 h after treatment.The occurrence time of ADRs was related to the type of medication(P<0.05).The severity of ADRs was correlated with the patient's age,body weight,occurrence time of ADRs and type of medication(P<0.05).Conclusion Strengthening the monitoring of the ADRs caused by anti-tumor drugs or adjuvant drugs,understanding the characteristics and rules of the ADRs,and doing a good job in prevention and treatment of ADRs can provide a reference for clinical safe,rational and personalized medication.